Background and Aim: Posterior dislocation of lens fragments is uncommon complication of
phacoemulsification. However it is associated with sight threatening sequelae. These may
include intraocular inflammation, secondary glaucoma, corneal edema, cystoid macular edema, and
retinal detachment. Proper management is crucial to reduce the risk of these complications.
Pars plana vitrectomy with intravitreal emulsification of dislocated lens fragments is indicated.
Optimal timing for intervention is controversial. This study aimed to determine clinical outcomes
and optical coherence tomography (OCT) changes of prompt, early and late pars plana
vitrectomy with and without the use of intravitreal ultrasonic emulsification for dislocated lens
fragments and/ or IOL. Methods: Thirty five eyes of 35 patients were recruited for the study. All
cases underwent pars plana vitrectomy (PPV) for dislocated nuclear fragments after complicated
phacoemulsification. A control group of 85 eyes with uneventful phacoemulsification were included.
The clinical outcomes were visual acuity, intraocular pressure (IOP) and postoperative
complications. OCT parameters including OCT-macula, OCT-Optic nerve head (ONH), and
anterior segment OCT were measured at the 1st, the 3rd, the 6th, the 9th, and 12th months
postoperatively. Results: The results illustrated that eight eyes (22.8%) had CME detected by
OCT at the 3rd months, while only 5 eyes (14.3%) at the 12th months and only 4 eyes (11.4%)
had chronic CME. Conclusion: Timing of PPV is an important factor affecting clinical and in
dislocated nuclear fragments and IOL. The prompt PPV was associated with the best outcome
followed by the early PPV. Cases in which, intravitreal ultrasound emulsification was indicated,
had poorer prognostic outcome.