Posterior vitreous detachment following cataract surgery

Abstract

Objective To determine the incidence of posterior vitreous detachment (PVD) in a series of patients who have undergone cataract surgery by phacoemulsification. Design Comparative case series Participants A consecutive series of 149 patients who underwent cataract surgery aged between 50 and 60 years were evaluated in this study. Methods Patients identified as being eligible for this study were recalled for an ophthalmic assessment, which included a dilated retinal examination. Main Outcome Measures The status of the vitreous was recorded following an evaluation by slit-lamp biomicroscopy, binocular indirect ophthalmoscopy, and B-scan ultrasonography.Results A PVD was documented in 50.8% of the pseudophakic eyes as compared to 20.8% in the phakic fellow eyes. This difference was statistically significant. Furthermore, the incidence of PVD was greater in pseudophakic eyes with an axial length of 25 mm or greater compared to those eyes with an axial length of o25 mm. Neodymium: yttrium garnet (Nd:YAG) capsulotomy did not influence the prevalence of PVD. In this series of eyes, with a median follow-up interval of 77 months the incidence of pseudophakic retinal detachment (PRD) was 4% Conclusions The incidence of PVD in pseudophakic eyes in the 6th decade is higher than those phakic eyes, and is likely to be associated with the increased risk of PRD observed in this age group.

Influence of Vitreomacular Adhesion on Anti-Vascular Endothelial Growth Factor Treatment for Neovascular Age-Related Macular Degeneration

“…Therefore, though not statistically significant, the presence of VMA was more common in phakic eyes, which is in accordance with the literature for such patients [33] .…”

Complications Associated with Cataract Surgery

“…The removal of the crystalline lens and its replacement with a thinner IOL implant leaves more space inside the globe for the vitreous to move forward which may induce a detachment from the posterior pole. The study also found that eyes with an axial length of more than 25mm were at increased risk of developing PVD (60). Rhegmatogenous retinal detachment (RRD) is rare but is a serious potential complication of cataract surgery.…”

“…A published study found a prevalence of PVD in 50.8% of eyes that had undergone cataract surgery compared to 20.8% in the fellow unoperated eye (60). The removal of the crystalline lens and its replacement with a thinner IOL implant leaves more space inside the globe for the vitreous to move forward which may induce a detachment from the posterior pole.…”

Retinal Complications after Damaging the Vitreolenticular Barrier

“…This might be explained – as already discussed above – by the higher rate of PVDs in the pseudophakic eye [8] leading to altered vitreous geometry offering enhanced vitreal moving possibilities. This would also explain the higher risk of RD even years after surgery if a PVD occurred after the operation but not necessarily before.…”

“…In this context it might be noteworthy that also in uncomplicated cataract surgery the rate of PVD is significantly higher than in phakic eyes. Hilford et al [8] observed a PVD rate of 50.8% in pseudophakic eyes versus 20.8% in phakic eyes. This can be explained by the increase in ‘vitreal space’ in the posterior segment after extracting the voluminous lens and exchanging it by a flat artificial lens.…”