ESCRS - POCAT564 - Timing Matters: Visual And Surgical Outcomes Of Secondary Iol Implantation Performed During Vs After Pars Plana Vitrectomy

Timing Matters: Visual And Surgical Outcomes Of Secondary Iol Implantation Performed During Vs After Pars Plana Vitrectomy

Published 2026 - 44th Congress of the ESCRS

Reference: POCAT564 | Type: Poster | DOI: 10.82333/cby5-d116

Authors: Mrs Larissa Valério Pedrosa* 1 , Mrs Anna Paula Nassaralla 2 , Mr Sergio Canabrava 3

1Cataract,Redemo Oftalmologia,Indaiatuba,Brazil, 2Centro Oftalmológico de MInas Gerais,Belo Horizonte,Brazil, 3Cataract,Centro Oftalmológico de MInas Gerais,Belo Horizonte,Brazil

Purpose

Secondary intraocular lens (IOL) implantation in aphakic or lens-destabilized eyes frequently requires pars plana vitrectomy (PPV). However, the ideal timing for IOL placement—simultaneous with PPV versus staged after prior PPV—remains uncertain. This study quantitatively compared postoperative outcomes between these two strategies and evaluated the influence of fixation technique and postoperative complications on visual results.

Setting

This retrospective observational study was conducted at the High-Performance Retina and Cataract Department of a public Ophthalmology Service in Belo Horizonte, Brazil.

Methods

A total of 91 eyes were assessed, of which 47 were excluded due to absence of secondary intraocular lens (IOL) implantation, insufficient documentation, or inadequate follow-up. Forty-four eyes undergoing secondary IOL implantation were divided into two groups: simultaneous pars plana vitrectomy (PPV) with IOL implantation (n = 27) and staged secondary IOL implantation after prior PPV (n = 17). Variables included pre and postoperative best-corrected visual acuity (BCVA), fixation technique (Yamane, 4-flanged, or 2-flanged), and postoperative complications, each analyzed as an individual event. Final BCVA was categorized as ≥20/40 (“good”), <20/40 (“poor”), or low vision (counting fingers, hand motion, or light perception).

Results

The 4-flanged technique predominated overall (27/44), whereas the Yamane technique was more frequently used in Group 1 (12/27). Good final BCVA (≥20/40) occurred in 11/17 eyes (64.7%) in Group 2 and 8/27 eyes (29.6%) in Group 1. At least one postoperative complication occurred in 13/27 eyes (48.1%) in Group 1 and 10/17 eyes (58.8%) in Group 2. After excluding posterior capsule opacification as a non-complication, both groups demonstrated 16 total complication events, corresponding to 0.59 events per eye in Group 1 and 0.94 per eye in Group 2.

Conclusions

Staged secondary IOL implantation after prior PPV resulted in a higher proportion of eyes achieving BCVA ≥20/40 compared with simultaneous PPV and IOL placement. Although both groups exhibited an equal number of total complication events, the staged approach showed a higher event rate per eye. Surgical timing and fixation technique selection should be individualized to optimize visual recovery while mitigating postoperative risk.