Surgical outcomes according to vitreous management after scleral fixation of posterior chamber intraocular lenses.

PURPOSE

To investigate the effect of vitreous management on surgical outcomes after scleral fixation of posterior chamber intraocular lenses.

METHODS

The medical records of 83 eyes from 83 patients, who underwent scleral fixation of posterior chamber intraocular lenses without any preexisting vitreoretinal complication and were followed up for ≥ 6 months, were reviewed retrospectively. Subjects were divided according to the strategy used for vitreous management into a pars plana vitrectomy (PPV) group (47 eyes) and an anterior vitrectomy (AV) group (36 eyes). Surgical outcomes were compared between the groups.

RESULTS

Both groups were comparable regarding demographics, follow-up period, and underlying ocular disease. The degree of visual improvement was similar in both groups (P = 0.911). Postoperatively, each group developed a myopic shift, which was greater in the PPV group than in the AV group (P = 0.040). Intraocular pressure elevations ≥ 25 mmHg occurred in 50% of eyes in the AV group and in 11% of eyes in the PPV group (P < 0.001). Intraocular lenses dislocated more frequently in the AV group (28%) than in the PPV group (9%; P = 0.036). Intraocular lens capture was more common in the PPV group (23%) than in the AV group (3%; P = 0.010). There was no significant difference in the rate of postoperative vitreoretinal complications.

CONCLUSION

In eyes that received scleral fixation of posterior chamber intraocular lenses, PPV decreased the chances of postoperative intraocular pressure elevation and intraocular lens dislocation but increased the likelihood of intraocular lens capture and the magnitude of postoperative myopic shift.