Risk Factors for Pseudophakic Retinal Detachment After Intraocular Lens Scleral Fixation With or Without Pars Plana Vitrectomy

Abstract

Performing PPV could be a risk factor of the pseudophakic retinal detachment after intraocular lens scleral fixation. If there is a choice, it should be decided carefully whether a PPV is performed at the time of intraocular lens scleral fixation.

Surgical Outcomes According to Vitreous Management After Scleral Fixation of Posterior Chamber Intraocular Lenses

“…First, PPV might prevent vitreous entwinement around a PCIOL by providing a much more thorough vitrectomy and capsulectomy. 3,5,11 However, this vitreous entwinement was absent when patients underwent a careful PPV and pars plana capsulectomy. The residual vitreous or lens capsule fragments might induce IOL kinking, which would in turn result in vitreoretinal traction.…”

“…Although complete PPV was suggested to reduce the risk of CME, the condition developed at similar rates in both groups. 8,11,13 Poor postoperative visual acuity was associated with glaucoma, preexisting amblyopia, or age-related macular degeneration. 6,8,19,26 This overall rate was reduced in this study (8%), perhaps because of the strict inclusion criteria.…”

“…31 Both vitreodonesis and vitreal turbulence represent forms of mechanical trauma that can induce retinal complications such as macular edema, retinal breaks, and even RD. 11 Meticulous surgical management by an experienced surgeon will reduce the frequency of iatrogenic retinal breaks. The threat of vitreous traction forces on the retina at the time of a future posterior vitreous detachment is also eliminated.…”

“…5 In many cases involving SFPCIOL, pars plana vitrectomy (PPV) is necessary because of the presence of a vitreoretinal complication such as a retinal detachment (RD) or an open-globe injury. [9][10][11] However, some researchers have suggested that performing an AV through the limbal approach does not result in the complete removal of the vitreous from the anterior chamber and ciliary sulcus, and thus causes entwinement of vitreous remnants around the IOL and consequent vitreoretinal traction. [9][10][11] However, some researchers have suggested that performing an AV through the limbal approach does not result in the complete removal of the vitreous from the anterior chamber and ciliary sulcus, and thus causes entwinement of vitreous remnants around the IOL and consequent vitreoretinal traction.…”

Interim Results from the International Trial of Second Sight's Visual Prosthesis

“…But in an effort to draw some comparisons, the following are the results from more complex procedures with implants: The rate of retinal detachment for sclerally fixated IOLs is reported between 8.5 – 9.5%. [20, 21] The rate of retinal detachment with Retisert implantation is between 1.5 – 2.2%, [22, 23] and with Vitrasert implantation has been reported as high as 13.8% [24] . Of course, one must consider that the target subject population for the Vitrasert (AIDS-related CMV) carried with it a higher risk of retinal detachment.…”