Total vitrectomy in crystalline lens

Objective:To invest the possibility and effect of total vitrectomy in crystalline lens.Methods:A consecutive 48 patients (50 eyes) with crystalline lens were enrolled for standard three port pars plana vitrectomy. The vitreous on the surface of vitreous base and pars plana were also excised during operation. These cases included 14 eyes of rhegmategeous retinal detachment (3 eyes of giant break),4 eyes of closed globe injury,11 eyes of open globe injury (purulent endophthalmitis in 2 eyes),7 eyes of macular diseases,5 eyes of miscellaneous vitreous hemorrhage,4 eyes of Eales' disease,3 eyes of acute retinal necrosis syndrome and 2 eyes of proliferative diabetic retinopathy. The visual acuity (VA),anterior segment of globe,fundus and introcular pressure were examined periodically after operation. The vitreous base and pars plana were examined with the depressing three mirror lens at the last follow up visit or were viewed during the second operation.Results:Sufficient total vitrectomy was performed in 38 eyes,partial total vitrectomy in 12 eyes. Non or mild vitreous incarceration in the sclerotomy sites accounted for 86% of all the eyes. Anterior proliferative vitreoretinopathy (APVR) did not occurred in the study. The accidental injury of the lens and the ciliary body didn't appear. The successful rate was 90% after the primary surgery and the last successful rate was 94% after the additional operations. The VA was improved significantly after operation (P0.05). The surgical complications were mainly iatrogenic retinal breaks,corneal epithelium edema,glaucoma,retinal redetachment,cataract during or after operation and those were related to sclerotomy sites.Conclusion:The total vitrectomy is feasible in crystalline lens. It can prevent or decrease the vitrectomic complications such as APVR and those related to sclerotomy sites.