Vitreoretinal Outcomes Following Secondary Intraocular Lens Implantation with Pars Plana Vitrectomy

Background: Retrospective cohort study of 561 adult patients undergoing secondary intraocular lens (IOL) implantation by vitreoretinal surgeons at a single institution from April 2015-December 2020. Methods: Patient historical factors, intraoperative/postoperative complications, and outcomes of IOL type (anterior chamber IOL (ACIOL) vs scleral sutured IOL (SSIOL) vs scleral fixated IOL (SFIOL) vs sulcus) were assessed. Primary outcomes were rates of postoperative retinal tears and rhegmatogenous retinal detachment (RRD). Secondary outcomes were rates of intraoperative endolaser, intraoperative retinal tear, and further IOL surgery. Results: The incidence of intraoperative retinal tears was 7.3% and not significantly different between techniques. Rates of intraoperative endolaser use were 17.5% among all techniques and not significantly different between techniques. Rates of postoperative retinal tear were low (0-2.7%). Rates of postoperative RRD were not significantly different between techniques [ACIOL 9/198 (4.5%), SFIOL 1/54 (1.9%), SSIOL 14/274 (5.1%), sulcus 2/35 (5.7%), total 26/561 (4.6%), p=0.79]. Rates of repeat IOL surgery trended higher in sulcus lenses [ACIOL 5/198 (2.5%), SFIOL 4/54 (7.4%), SSIOL 16/274 (5.8%), sulcus 5/35 (14.3%), total 30/561 (5.3%), p=0.12]. Conclusions: Intraoperative endolaser use and intraoperative retinal tear were not uncommon in secondary IOL surgery and underscore the importance of careful vitreoretinal management among these patients.