Retained Lens Fragments After Cataract Surgery: Comparing Outcomes of Same-Day vs. Delayed Pars Plana Vitrectomy

Abstract

Background: Retained lens fragments following cataract surgery can lead to significant visual impairment and complications. The timing of pars plana vitrectomy (PPV) for their removal remains a subject of debate, with uncertainty regarding the benefits of Same-Day PPV versus Delayed PPV.

Aim: To compare the visual outcomes, postoperative complications, and recovery in patients undergoing Same-Day versus Delayed PPV for retained lens fragments after cataract surgery.

Methods: Ninety patients who had PPV for retained lens fragments participated in a retrospective comparison research. There were two groups of patients: Same-Day PPV (n = 45) and Delayed PPV (n = 45). SPSS version 23.0 was used to evaluate data on best-corrected visual acuity (BCVA), postoperative complications, surgery time, and hospital stay; a p-value of less than 0.05 was deemed statistically significant.

Results: The Same-Day PPV group had significantly better BCVA at 1 month (0.6 ± 0.4 vs. 0.9 ± 0.5, p = 0.003) and 3 months (0.4 ± 0.3 vs. 0.7 ± 0.4, p = 0.002) compared to the Delayed PPV group. Postoperative complications, including cystoid macular edema (8.9% vs. 22.2%, p = 0.04) and elevated intraocular pressure (13.3% vs. 26.7%, p = 0.03), were significantly lower in the Same-Day PPV group. Surgical time and hospital stay were also significantly shorter (p = 0.01 and p < 0.001, respectively).

Conclusion: Same-Day PPV offers superior visual outcomes, fewer complications, and faster recovery compared to Delayed PPV in cases of retained lens fragments. Early surgical intervention minimizes inflammation and optimizes patient prognosis.

Recommendations: Same-Day PPV should be considered the preferred approach whenever feasible to improve outcomes and reduce healthcare burden. To confirm these results, more prospective, randomized research is advised.

Keywords: Retained lens fragments, pars plana vitrectomy, cataract surgery, visual outcomes, postoperative complications.