23-Gauge transconjunctival sutureless vitrectomy for retained lens fragments after complicated cataract surgery.

PURPOSE: The purpose of this study was to evaluate the effectiveness and safety of 23-gauge (23-G) transconjunctival sutureless vitrectomy in patients with retained lens fragments after complicated cataract surgery.

METHODS

In this retrospective consecutive case series, 17 eyes of 17 patients with retained lens fragments after complicated cataract surgery and managed by using 23-G transconjunctival sutureless vitrectomy were evaluated between January 2007 and March 2009 at our institution.

RESULTS

Mean follow-up time was 8.5 ± 3.00 months. Nine patients (53%) were pseudophakic, and 8 (47%) were aphakic. A foldable acrylic intraocular lens was implanted in eight eyes with aphakia. In 2 eyes (11.8%), one of 23-G sclerotomy port was enlarged and intravitreal phacoemulsification was performed with 20-gauge phacofragmatome to remove hard nucleus. Visual acuity improved in 100% of eyes and was 20/40 or better in 70.6% of eyes. Postoperative complications were transient elevation of intraocular pressure (29.4%), decentralization of the intraocular lens (5.9%), fibrin reaction (5.9%), mild vitreous hemorrhage (5.9%), and macular retinal pigment epithelial changes (5.9%).

CONCLUSION

Twenty-three-gauge transconjunctival sutureless vitrectomy was observed to be effective and safe in patients with retained lens fragments after complicated cataract surgery. In cases with hard nucleus, 23-G vitrectomy probe may not be adequate to remove the lens fragments.