Cataract Following Pars Plana Vitrectomy: A Review

Hernández-Bogantes, Erick; Abdala-Figuerola, Alexandra; Olivo-Payne, Andrew; Quiros, Fabian; Wu, Lihteh

doi:10.1080/08820538.2021.1924799

Cited by 13 publications

(12 citation statements)

References 81 publications

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“…Three parameters in this study were significantly correlated with cataract progression: patient age, the use of PDMS tamponade and the macular involvement by the original RRD. The correlation with the patient age at the time of the PPV was already evident in the univariate analysis, and in line with former or more recent literature reports 17 , 18 . In older patients (at the time of PPV), the CES indication was earlier, with the hazard ratio approximately doubling for every 5-year increase in age.…”

Section: Discussionsupporting

confidence: 90%

Cataract progression following lens-sparing pars plana vitrectomy for rhegmatogenous retinal detachment

Bellucci

Benatti

Rossi

et al. 2022

Sci Rep

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Lens-sparing pars plana vitrectomy (PPV) is often followed by cataract development. However, there have been few prospective studies evaluating the timing of cataract progression and potential associated factors. This was an observational study conducted at the Ophthalmology Unit of the University Hospital of Parma (Parma, Italy). Patients presenting with rhegmatogenous retinal detachment (RRD), who underwent PPV with preservation of the lens, were examined according to a scheduled follow-up (3, 6 and 12 months after PPV) and then preoperatively when cataract extraction surgery (CES) was indicated, or at the end of the study follow-up period (May 2021). The primary outcome was the interval between PPV and CES indication (based on predefined refractive criteria). A total of 36 eyes of 36 patients (mean age: 52 ± 10 years) were included in the study. Nineteen eyes (53%) were indicated for CES a median of 14.5 months (IQR: 12.0–24.8) after PPV. The nuclear and posterior subcapsular forms of cataract progressed significantly starting at 6 months after PPV. Older age at the time of PPV, silicone oil tamponade and RRD without macular involvement were significantly and independently associated with an earlier indication for CES. Patient age and the use of silicone oil tamponade must be taken into consideration when evaluating the risk of cataract development after PPV.

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Section: Discussionsupporting

confidence: 90%

Cataract progression following lens-sparing pars plana vitrectomy for rhegmatogenous retinal detachment

Bellucci

Benatti

Rossi

et al. 2022

Sci Rep

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“…This may account for the poor postoperative visual acuity observed in eyes treated with silicone oil tamponade. Cataract formation is a common complication of vitrectomy [22] , which can impair postoperative visual acuity, which is why many retinal surgeons prefer phacovitrectomy for older patients, which can save money and avoid the need for additional cataract surgery. Additionally, retinal surgeons may benefit from enhanced visibility and the ability to perform more extensive vitrectomy while in an aphakic state during surgery.…”

Section: Discussionmentioning

confidence: 99%

Prognosis value of Chinese Ocular Fundus Diseases Society classification for proliferative diabetic retinopathy on postoperative visual acuity after pars plana vitrectomy in type 2 diabetes

Cheng¹,

Pazo²,

Dai³

et al. 2022

Int J Ophthalmol

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AIM: To compare the postoperative visual acuity among eyes with proliferative diabetic retinopathy (PDR) of different stages after pars plana vitrectomy (PPV) in type 2 diabetic patients. METHODS: A retrospective study was conducted for PDR eyes undergoing PPV in type 2 diabetic patients. All patients were divided into three groups based on Chinese Ocular Fundus Diseases Society (COFDS) classification for PDR: Group A (primary vitreous hemorrhage), Group B (primary fibrovascular proliferation) and Group C (primary vitreous hemorrhage and/or fibrovascular proliferative combined with retinal detachment). The postoperative visual acuity and the change between postoperative and preoperative visual acuity were compared among three groups. The associated risk factors for postoperative visual acuity were analyzed in the univariate and multiple linear aggression. RESULTS: In total, 195 eyes of 195 patients were collected in this study, including 71 eyes of 71 patients in Group A, 75 eyes of 75 patients in Group B and 49 eyes of 49 patients in Group C. The eyes in Group A got better postoperative best-corrected visual acuity (BCVA) compared to the eyes in Group B and C (0.48±0.48 vs 0.89±0.63, P<0.001; 0.48±0.48 vs 1.04±0.67, P<0.001; respectively). The eyes in Group A got more improvement of BCVA compared to the eyes in Group B and C (1.07±0.70 vs 0.73±0.68, P=0.004; 1.07±0.70 vs 0.77±0.78, P=0.024; respectively). In the multiple linear regression analysis, primary fibro-proliferative type (β=0.194, 95%CI=0.060-0.447, P=0.01), retinal detachment type (β=0.244, 95%CI=0.132-0.579, P=0.02), baseline logMAR BCVA (β=0.192, 95%CI=0.068-0.345, P=0.004), silicone oil tamponade (β=0.272, 95%CI=0.173-0.528, P<0.001) was positively correlated with postoperative logMAR BCVA. Eyes undergoing phacovitrectomy had better postoperative BCVA (β=-0.144, 95%CI=-0.389 to -0.027, P=0.025). CONCLUSION: PDR eyes of primary vitreous hemorrhage type usually have better visual acuity prognosis compared to primary fibrovascular proliferation type and retinal detachment type. COFDS classification for PDR may have a high prognostic value for postoperative visual outcome and surgical management indications.

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“…However, details of endotamponade, laser retinopexy, and cryopexy use were inconsistently reported among included studies [62, 63]. Further, we were unable to assess cataract grade of included eyes at baseline, and predisposing conditions such as diabetes and steroid use, given a paucity of baseline patient and ocular characteristics across included studies [64, 65].…”

Section: Discussionmentioning

confidence: 99%

Scleral Buckling Alone or in Combination with Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment Repair: A Meta-Analysis of 7,212 Eyes

et al. 2022

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Purpose: The efficacy and safety of scleral buckling (SB) versus combination SB and pars plana vitrectomy (SB+PPV) for rhegmatogenous retinal detachment (RRD) repair remains unclear. Methods: A systematic review and meta-analysis was conducted to identify comparative studies published from Jan 2000-Jun 2021 that reported on the efficacy and/or safety following SB and SB+PPV for RRD repair. Final best-corrected visual acuity (BCVA) represented the primary endpoint, while reattachment rates and ocular adverse events were secondary endpoints. A random-effects meta-analysis was performed, and 95% confidence intervals were calculated. Results: Across 18 studies, 3912 SB and 3300 SB+PPV eyes were included. Final BCVA was non-significantly different between SB and SB+PPV (20/38 vs. 20/66 Snellen; WMD=–0.11 LogMAR; 95%CI [–0.29,0.07]; P=0.23). Primary reattachment rate was similar between procedures (P=0.74); however, SB alone achieved a significantly higher final reattachment rate (97.40% vs. 93.86%; RR=1.03; 95%CI [1.00,1.06]; P=0.04). Compared to SB+PPV, SB alone had a significantly lower risk of postoperative macular edema (RR=0.69; 95%CI [0.47,1.00]; P=0.05) and cataract formation (RR=0.34; 95%CI [0.12,0.96]; P=0.04). The incidence of macular hole, epiretinal membrane, residual subretinal fluid, proliferative vitreoretinopathy, elevated intraocular pressure, and extraocular muscle dysfunction were similar between SB and SB+PPV. Conclusions: There was no significant difference in final BCVA between SB+PPV and SB alone in RRD. SB alone offers a slightly higher final reattachment rate along with a reduced risk of macular edema and cataract. Primary reattachment rate and the incidence of other complications were similar between the two procedures.

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Cataract Following Pars Plana Vitrectomy: A Review

Cited by 13 publications

References 81 publications

Cataract progression following lens-sparing pars plana vitrectomy for rhegmatogenous retinal detachment

Cataract progression following lens-sparing pars plana vitrectomy for rhegmatogenous retinal detachment

Prognosis value of Chinese Ocular Fundus Diseases Society classification for proliferative diabetic retinopathy on postoperative visual acuity after pars plana vitrectomy in type 2 diabetes

Scleral Buckling Alone or in Combination with Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment Repair: A Meta-Analysis of 7,212 Eyes

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