INCIDENCE OF LENS TOUCH DURING PARS PLANA VITRECTOMY AND OUTCOMES FROM SUBSEQUENT CATARACT SURGERY

Purpose:To determine the incidence of lens touch during pars plana vitrectomy (PPV) and evaluate cataract surgery complications after lens touch.Methods:One thousand three hundred and ninety nine phakic patients who underwent PPV during the period from 2001 to 2013 were included in the study. Data of the PPV and lens touch (excluding lens bite) complications were reviewed from an electronic database (VITREOR). Subsequent cataract surgery data and intraoperative complications were reviewed. A control group consisted of 149 cases of phakic patients who underwent PPV with no lens touch then subsequent cataract surgery. All surgeries were performed by senior surgeons, and no cataract was present before the PPV.Results:The incidence of lens touch was 3.7% (52 of 1,399 phakic patients). The Demographics and presenting complaints of the patients were not significantly associated with lens touch, but retinal detachment with proliferative vitreoretinopathy, the use of silicone oil and use of relaxing retinectomy were associated with more lens touch. Cataract developed in 49 patients of whom 45 underwent cataract surgery. Nuclear sclerosis developed in 22 patients, 16 had posterior subcapsular, 8 had mixed lens opacities, and 3 had white cataract. The median duration between PPV and cataract surgery was 4 months in the lens touch group, which was significantly shorter than the median of 8 months in the control group (P = 0.001). During the subsequent cataract surgery in the lens touch group, 5 patients (11%) had a posterior capsule rupture, whereas the control group had only 2 cases of posterior capsule rupture 1.4% (P = 0.008). Final visual acuity was 0.3 LogMar or better in 22 patients (44%).Conclusion:Lens touch is a frequent complication of PPV in a phakic eye. It is more common in patients having surgery for proliferative vitreoretinopathy. Care should be taken when performing subsequent cataract surgery on an eye with lens touch as it carries a significantly increased chance of posterior capsule rupture.