Pars plana vitrectomy and intravitreal phacoemulsification for dropped nuclei

Purpose: To report the outcomes of pars plana vitrectomy (PPV) and intravitreal phacoemulsification in patients with dropped nuclei/nuclear fragments following complicated cataract surgery. Methods: In this retrospective case series, charts of patients who had undergone PPV and intravitreal phacoemulsification for removal of dislocated nuclei/lens fragments were reviewed. After standard PPV, a conventional phacoemulsification probe with an amputated sleeve was used for grasping and emulsifying the nucleus/nuclear fragments in mid/anterior vitreous cavity. Pre- and postoperative visual acuity, and intra- and postoperative complications were recorded. Results: A total of 22 patients with mean age of 71.1±8.2 years were studied. Mean interval between complicated cataract surgery and PPV was 26.6±36.5 (range: 0-120) days. Patients were followed for a mean of 105.5±57.5 days. Preoperatively, best corrected visual acuity was 2.4±0.6 logMAR which was improved to 1.4±0.6 logMAR at final follow-up (P<0.001). Intraoperative complications included iatrogenic peripheral retinal breaks in three eyes. Postoperative complications consisted of epiretinal membrane formation in one eye, hypotony in one eye, and medically-controlled glaucoma in 2 eyes. Conclusion: In this series, PPV and intravitreal phacoemulsification using a conventional phacoemulsification probe in patients with dropped nuclei/nuclear fragments following complicated cataract surgery resulted in visual improvement without any complications directly attributable to the probe.