Anatomical and visual outcome of pars plana vitrectomy after dropped nucleus by eventful phacoemulsification.

Abstract

objective: To study the anatomical and visual outcomes of patients who underwent pars plana vitrectomy for dropped nucleus or fragments of nucleus after eventful phacoemulsification. Study Design: Retrospective Quasi Experimental study. Setting: Department of Ophthalmology, Allied Hospital, PMC, FMU, Faisalabad. Period: 01-01-2022 to 01-01-2023. Material & Methods: Thirty five patients having event full phacoemulsification for dropped nucleus (Full, Half or less than half) were enrolled for either PPV with Phaco-fragmentation or PPV with vitreous cutter removal and PPV with limbal removal of nucleus. The intraocular lens was implanted at same time, or after one week or later depending upon the condition of eye. Initial examination included, visual acuity, IOP, B Scan, status of cornea, hyphema or hypopyon. Postoperative follow up period was two weeks to assess visual acuity, corneal clarity, retinal anatomy and any complications. Results: Out of 35 patients 24 (68.57%) were male and 11 (31.43%) were female. Age ranged between 30 to 70 years. There were 12 (34.28%) patients between age 30 to 50 years and 23 (65.72%) patients between aged 51 to 70 years. There were 13 (37.17%) patients from Eye Department, Allied Hospital, PMC, FMU, Faisalabad and 22 (62.86%) patients enrolled as referred from different districts of the Punjab. Initial vision was PL+ in one patient (2.86%) HM to CF in 28 patients (80%), 6/60 to 6/24 in 6 patients (17.15%) while no patient (0%) had vision of 6/9 to 6/6. while final vision was up to HM to CF in 10 patients (28.57%), 6/60 to 6/24 in 18 patients (51.43%), 6/18 to 6/9 in 10 patients (28.57%), none of patient gained vision of 6/6. Corneal haze was in 7 (20%) patients, CME in 2 (5.71%), RD in 2 (5.71%), hyphema in 1 (2.86%) patient, raised IOP was in 8 (22.86%) patients while 15 (42.86%) patients had satisfactory condition. Conclusion: The loss of cataractous lens in vitreous cavity is severe complication during phacoemulsification. The early retrieval of nucleus by PPV, phaco-fragmentation, limbal removed or with vitreous cutter can improve the anatomical and visual outcomes.