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Dropped Nucleus: Earlier the Vitrectomy Better the Results

Ashish Kakkar , Rupali Tyagi1 , Ashish Kakkar2

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Ophthalmology and Allied Sciences 5(1):p 119-124, January-April 2019. | DOI: DOI: http://dx.doi.org/10.21088/oas.2454.7816.5119.21

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Abstract

 Aim: To determine safety and efficacy of pars plana vitrectomy (PPV) for dropped nucleus after complicated cataract surgery and evaluate the correlation of final visual acuity with time interval lapsed till active intervention done. Material and methods : We did a retrospective analysis of patients who underwent PPV for dropped nucleus in cataract surgery from july 2014 to August 2018 at SGRRIM & HS, Dehradun, India. The data was recorded in terms of details of complicated cataract surgery , point of occurrence of dropped nucleus, time elapsed till PPV done, the intraoperative and postoperative complications. Final outcome measures were the best corrected visual acuity (BCVA) at three months follow up and its correlation with time at which PPV was done. Results: Out of 14 cases of dropped nucleus during this four year period of study 3 (21.4%) patients were referred from outside , while 11 patients (78.5%) had the complication in our hospital itself of total 5760 cataract surgeries done contributing to an incidence of 0.191%. PPV was done in the same sitting in majority of cases (57.1%) with BCVA, 6/18 or better at the last follow up. One eye had retinal detachment two months postoperatively for which fluid/gas exchange was performed. All patients (92.9%) had IOL implantation except one (7.1%) who had corneal decompensation. The correlation between BCVA at three months follow up and time interval between complicated cartaract surgery and PPV was statistically significant (χ2 = 14.000, p = 0.003) , all those patients (21.4%) who were referred late and operated after one week had vision less than 6/60. Conclusion: Though dropped nucleus is a sight threatening complication of cataract surgery, PPV if done on time is safe and effective and the final visual outcome is definitely better in patients who get intervened early. However future studies with larger sample size and longer follow up are required to confirm our results.

Keywords: Dropped Nucleus; Vitrectomy; Visual Acuity.

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DOI: DOI: http://dx.doi.org/10.21088/oas.2454.7816.5119.21

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