Outcomes of Anterior Chamber Intraocular Lens Implantation in Patients Undergoing Pars Plana Vitrectomy

Purpose: To assess outcomes and complication rates in patients undergoing pars plana vitrectomy (PPV) and implantation of an anterior chamber intraocular lens (ACIOL). Design: Retrospective chart review. Participants: A total of 50 eyes that underwent secondary ACIOL placement in the setting of concurrent PPV from October 2000 to August 2016 were included. Methods: A retrospective chart review was conducted. Main Outcome Measures: The primary outcome measure was the occurrence of postoperative complication including persistently elevated intraocular pressure, persistent or recurrent hyphema, persistent or recurrent vitreous hemorrhage, persistent corneal edema, or persistent uveitis, macular edema, epiretinal membrane, lens dislocation, retinal tear, or retinal detachment. The secondary outcome measure was best-corrected visual acuity (BCVA). Results: Postoperative complications occurred as follows: persistently elevated intraocular pressure in 4 eyes (8%), persistent corneal edema in 1 eye (2%), persistent postoperative uveitis in 1 eye (2%). Seven eyes (14%) had new macular edema and 2 eyes (4%) had new epiretinal membranes after combined PPV and ACIOL surgery. No patient had persistent postoperative hyphema, vitreous hemorrhage, retinal tear, retinal detachment, or lens dislocation after ACIOL placement. Mean preoperative BCVA was 20/200 (logarithm of the minimum angle of resolution 0.96) and improved to 20/40 (logarithm of the minimum angle of resolution 0.28, P <= 0.0001) at 1 year postoperatively. Conclusions: Whereas there is a recent emphasis on new intraocular lens placement techniques in the setting of PPV including sutured and scleral-fixated intraocular lenses, ACIOL placement in the setting of concurrent PPV is a safe procedure, with few eyes developing long-term complications if careful case selection is employed. (C) 2018 by the American Academy of Ophthalmology