Timing of vitrectomy for retained lens fragments
Reviewed by Saruban Pasu

The purpose of this study was to compare the results of same setting vitrectomy with delayed vitrectomy for retained lens fragments following cataract surgery. Same setting vitrectomy was defined as the patient not leaving the operating table following cataract surgery. Significantly delayed surgery was defined as vitrectomy occurring more than 28 days after phacoemulsification. The authors retrospectively looked at 28 eyes (13 same setting, 15 delayed setting). Pre-cataract extraction, there were no significant differences in axial length, IOP, or median BCVA between the two groups. The mean time from cataract extraction to vitrectomy was 26.6 days in the delayed group. More eyes in the delayed group had IOL insertion at the time of cataract surgery, before vitrectomy. There were no differences between the groups in change of BCVA from initial pre-cataract visit to the most recent examination. Although not significant, there was a trend for same setting eyes to achieve good vision faster. More eyes in the delayed group had an IOP greater than 30mmHg at some time point during the postoperative course. Seven eyes were in the significantly delayed group, all of whom showed no significant difference from the same setting group regarding any follow-up outcomes. The authors conclude that although same setting surgery offers no significant acuity advantage over delayed surgery, in patients with advanced glaucoma where an IOP of more than 30 would not be desirable, same setting surgery may be advantageous.

A comparison of same setting versus delayed vitrectomy in the management of retained lens fragments after cataract surgery.
Orlin A, Parlitsis G, Chiu Y, et al.
RETINA
2014;34:1969-76.