Time to pars plana vitrectomy in adults with retained lens fragments: a systematic review and meta-analysis

Michelle Lim; Irina Sverdlichenko; Elizabeth Y Wei; Andrew Mihalache; Marko M Popovic; Mohammed Alfalah; Miguel Cruz Pimentel; Rajeev H Muni; Peter J Kertes

doi:10.1016/j.jcjo.2024.08.008

Time to pars plana vitrectomy in adults with retained lens fragments: a systematic review and meta-analysis

Can J Ophthalmol. 2024 Sep 7:S0008-4182(24)00254-0. doi: 10.1016/j.jcjo.2024.08.008. Online ahead of print.

Authors

Michelle Lim¹, Irina Sverdlichenko¹, Elizabeth Y Wei¹, Andrew Mihalache¹, Marko M Popovic², Mohammed Alfalah³, Miguel Cruz Pimentel², Rajeev H Muni⁴, Peter J Kertes⁵

Affiliations

¹ Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
² Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.
³ Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; College of Medicine, King Faisal University, Ahsa, Saudi Arabia.
⁴ Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; Department of Ophthalmology, St. Michael's Hospital/Unity Health Toronto, Toronto, ON, Canada.
⁵ Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; John and Liz Tory Eye Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. Electronic address: peter.kertes@sunnybrook.ca.

PMID: 39255952
DOI: 10.1016/j.jcjo.2024.08.008

Abstract

Objective: To compare visual outcomes and complication risk based on the timing of pars plana vitrectomy (PPV) following cataract surgery with retained lens fragments.

Methods: MEDLINE (Ovid), EMBASE, and Cochrane Library were searched between 2000 to February 2022 for studies comparing visual outcomes and complications based on time to PPV. Discrete outcomes were analyzed using a random-effects meta-analysis model on Review Manager (RevMan 5.4). The certainty of evidence of outcomes was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation approach.

Results: Ten studies and 1,693 eyes were included. The incidence of patients achieving a final best-corrected visual acuity (BCVA) of >6/12 Snellen may be similar among patients receiving PPV within 1 week or after 1 week of cataract surgery (RR = 1.06, 95% CI = [0.96, 1.17], p = 0.25), and patients receiving PPV within 1 month or after 1 month of cataract surgery (RR = 1.12, 95% CI = [0.95, 1.32]; p = 0.18). Incidence of glaucoma or elevated intraocular pressure for patients may be similar among patients receiving PPV within 1 week or after 1 week of cataract surgery (RR = 1.08, 95% CI = [0.62, 1.87]; p = 0.79), and patients receiving PPV within 1 month or after 1 month of cataract surgery (RR = 0.33, 95% CI = [0.09, 1.23]; p = 0.10).

Conclusion: Incidence of patients achieving a final BCVA of >6/12 Snellen or postoperative adverse effects was similar between patients who underwent early and late PPV following cataract surgery. However, all studies had an overall serious risk of bias, primarily because of confounding and reporting bias.