Indications for Posterior Segment Intervention Following Complicated Cataract Surgery

Rita Ehrlich, Philip Polkinghorne

Purpose: Examine the indications for posterior segment intervention following recent complicated cataract surgery

Methods: Retrospective review of patients that had complicated cataract surgery using phacoemulsification techniques in the past 5 years. Patients were initially identified from electronic records where a code of phacoemulsification and anterior vitrectomy was entered. A secondary search was made of those patients having posterior segment surgery coded as pars plana vitrectomy or buckle procedure. We excluded patients having a diagnosis of endophathalmitis. Data collection included the duration between the cataract surgery and posterior segment intervention, status of surgeon, pre and intra-operative risk factors, as well as the indications for posterior segment surgery together the anatomical and functional outcome.

Results: Twenty three patients were included in the study. The mean age was 75.3 years (SD 9.3), and mean follow up was 19.1 months (SD 15.2). The indications for surgery included dislocated crystalline lens fragments (n=16), rhegmatogenous retinal detachment (n=4),chronic cystoid macular edema (n=1), glaucoma hyphema and uveitis syndrome (n=1) and one case for severe post operative inflammation. The initial mean visual acuity was LogMAR 1.02 (SD 0.7) while the final mean visual acuity was LogMAR 0.6 (SD 0.76) (P=0.04). In all, 13 patients had final visual acuity of 20/40 or better. The retina was attached in all but one patient who developed severe proliferative vitreoretinopathy.

Conclusion: In our facility the most frequent indication for posterior pars plana vitrectomy following complicated cataract surgery is dislocated lens fragments.