Vitrectomy timing for retained lens fragments after surgery for age-related cataracts: A systematic review and meta-analysis

Elizabeth A. Vanner, Michael W. Stewart

Research output: Contribution to journalArticlepeer-review

32 Scopus citations

Abstract

Purpose: To evaluate the effect of vitrectomy timing on outcomes for patients with crystalline retained lens fragments receiving vitrectomy 3+ days after cataract surgery. Design: Systematic review and meta-analysis of retrospective interventional cases series. Methods: Searches of MEDLINE (English, 1/1/85 through 7/30/2010) and article reference lists. Articles were screened for patients with crystalline retained lens fragments after surgery for age-related cataracts, discussion of vitrectomy timing, and, for the meta-analysis, patient totals for at least 1 outcome and multiple time periods, 10+ patients, and mean follow-up <3 months. Outcomes included visual acuity, retinal detachment, increased intraocular pressure, intraocular infection/inflammation, cystoid macular edema, and corneal edema. Data extraction was performed twice and quality assessed. Logistic regression estimated study-level odds ratios for each additional 1-week vitrectomy delay. Meta-analysis estimated summary odds ratios using random-effects models. Results: Of 257 articles identified, there were 43 unique studies (53 articles) for the systematic review, including 27 (31 articles) for the meta-analysis. Early vitrectomies were statistically significantly associated with better outcomes for not good visual acuity (odds ratio: 1.13; 95% CI: 1.041.22, P =.005); bad visual acuity (odds ratio: 1.05; 95% CI: 1.011.09, P =.009); previtrectomy retinal detachment (odds ratio: 1.29; 95% CI: 1.011.65, P =.038); postvitrectomy retinal detachment (odds ratio: 1.13; 95% CI: 1.021.26, P =.024); increased intraocular pressure (odds ratio: 1.23; 95% CI: 1.071.41, P =.003); and intraocular infection/inflammation (odds ratio: 1.20; 95% CI: 1.011.42, P =.041). Results were robust to sensitivity analyses. Conclusions: This systematic review and meta-analysis found significantly better outcomes (visual acuity, retinal detachment, increased intraocular pressure, intraocular infection/inflammation) with earlier vitrectomy for retained lens fragments. Reduced vitrectomy delays may yield better patient outcomes.

Original languageEnglish (US)
Pages (from-to)345-357.e3
JournalAmerican journal of ophthalmology
Volume152
Issue number3
DOIs
StatePublished - Sep 2011
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

Fingerprint

Dive into the research topics of 'Vitrectomy timing for retained lens fragments after surgery for age-related cataracts: A systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this