Prognostic Factors that Determine Visual Outcome following Cataract Surgery Complicated by Vitreous Loss

Konstantopoulos, Aristides; Yadegarfar, Ghasem; Madhusudhana, Krishnappa C; Canning, C R; Luff, A J; Anderson, David F.; Hossain, Parwez

doi:10.1177/112067210901900212

Cited by 9 publications

(11 citation statements)

References 16 publications

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“…In our study the rate of tomographic CMO was about 31%. In the literature, the reported percentage of clinical CMO following intraoperative complication varies widely from 1.7% to 10% [2,9,15-18]. We note that these studies were designed primarily to study visual outcome and not specifically to detect CMO.…”

Section: Discussionmentioning

confidence: 99%

Spectral-domain optical coherence tomography evaluation of postoperative cystoid macular oedema following phacoemulsification with intraoperative complication

et al. 2014

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BackgroundTo report the rate of cystoid macular oedema (CMO) as detected by spectral-domain optical coherence tomography (SD-OCT) after intraoperative complication during phacoemulsification. The secondary objectives include comparing mean macular thickness and best-corrected visual acuity (BCVA) between those who developed postoperative CMO against those who did not.MethodsThis is a prospective cohort study conducted in a tertiary hospital between July 2009 and June 2010. Serial SD-OCT and BCVA were performed at baseline, 1 week, 6 weeks and 16 weeks postoperatively.ResultsSingle eyes from 47 subjects were analyzed; of these 16 (34%) eyes developed CMO. In the CMO group, mean macular thickness (±SD) increased sharply by 56 μm from 273 ± 24 μm at baseline to 329 ± 31 μm at 16 weeks; whereas in the non-CMO group, macular thickness showed a slight increase of 14 μm from 259 ± 21 μm to 272 ± 20 μm. In the CMO group, mean BCVA (in logarithm of minimum angle of resolution) improved modestly from 0.92 ± 0.66 to 0.66 ± 0.41 at week 16; while in the non-CMO group, mean BCVA improved markedly from 0.98 ± 0.59 to 0.21 ± 0.13. The two groups differed significantly in mean macular thickness (p < 0.001) and mean BCVA (p < 0.001) at 16 weeks.ConclusionAs detection rate of CMO is high, postoperative OCT monitoring for patients with intraoperative complications allows earlier diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

Spectral-domain optical coherence tomography evaluation of postoperative cystoid macular oedema following phacoemulsification with intraoperative complication

et al. 2014

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“…Another statistical significance analysis, with studies separated into MCF+ (Figure 2B) and MCF− (Figure 2C), indicted that SD-PPV might have produced better outcomes in MCF+ studies2,7,11,17–19,22,24,25,27,30,32,35,40,44,45 but not in MCF− studies 3,6,12,14,15,26,29,31,34,43Table 3 compares the percent of SD-PPV and DEL-PPV patients with each outcome, by MCF policy status.…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis comparing same-day versus delayedvitrectomy clinical outcomes for intravitreal retained lens fragments after age-relatedcataract surgery

Vanner¹,

Stewart²

2014

OPTH

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Purpose/designWe aimed to perform a systematic review and meta-analysis comparing the risk difference of clinical outcomes for same-day (SD) vs delayed (DEL) pars plana vitrectomy (PPV).MethodsWe searched MEDLINE (English; January 1, 1985 to July 16, 2013) and article reference lists, for patients with crystalline retained lens fragments and discussion of SD-PPV vs DEL-PPV. For the meta-analysis, articles needed the number of patients receiving SD-PPV and DEL-PPV, and the number, in each group, who experienced one or more of the outcomes: not good visual acuity (VA) (<20/40), bad VA (≤20/200), retinal detachment, increased intraocular pressure/glaucoma, intraocular infection/inflammation, cystoid macular edema, and corneal edema.ResultsOf 304 articles identified, 23 provided data for the meta-analysis. Results were mixed, indicating 1) neither vitrectomy time produced better outcomes in all studies (not good VA risk difference =10.3% [positive numbers favored SD-PPV; negative numbers favored DEL-PPV], 95% confidence interval [CI] = [−0.4% to 21.0%], P=0.059; and bad VA risk difference =−0.3%, 95% CI = [−10.7% to 10.1%], P=0.953); 2) better outcomes with immediate SD-PPV compared with all DEL-PPV (not good VA risk difference =16.2%, 95% CI = [0.8% to 31.5%], P=0.039; and bad VA risk difference =8.5%; 95% CI = [0.8% to 16.2%], P=0.030); and 3) immediate SD-PPV and prompt DEL-PPV (3 to 14 days after cataract surgery) had no significant differences and so may produce similar outcomes (not good VA risk differences range = [−19.9% to 6.5%], 95% CI = [−59.9% to 36.4%]; and bad VA risk differences range = [−6.9% to 7.4%], 95% CI = [−33.1% to 31.8%]).ConclusionPerhaps SD-PPV should be limited to facilities at which a vitreoretinal surgeon is immediately available. Otherwise, these results support referring a patient with retained lens fragments promptly to a vitreoretinal surgeon but do not support interfacility transport for SD-PPV.

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“…Studies with a higher number of patients evaluating cataract surgeries complicated by posterior capsular tear report 6.8%,7 8.7%,8 and 10%9 incidences of CME. Several studies reported varying incidences of postoperative CME 1–5,10.…”

Section: Discussionmentioning

confidence: 97%

Quantitative analysis of macular thickness following uneventful and complicated cataract surgery

Akçay¹,

Bozkurt²,

Güney³

et al. 2012

OPTH

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PurposeTo compare change of macular thickness after uneventful cataract surgery and after cataract surgery complicated with vitreous loss, using optic coherence tomography (OCT).MethodsTwenty eyes of 20 patients who underwent cataract surgery complicated with posterior capsular tear participated in this retrospective study (Group 2). The fellow eyes of those patients who underwent uneventful cataract surgery served as the control group (Group 1). Best spectacle-corrected visual acuity (BCVA), refraction, keratometry, axial length measurement, intraocular lens power calculation, intraocular pressure, and biomicroscopic and posterior segment examinations were done preoperatively. BCVA was evaluated at the postoperative 1st day, 1st week, 1st month, and 3rd month. Macular thickness and volumetric measurements with OCT with MM5 protocol were conducted at the postoperative 3rd month.ResultsLogarithm of the minimum angle of resolution BCVA of Group 1 was significantly better than Group 2 at all intervals (P < 0.05). Foveal, parafoveal (superior and temporal), and perifoveal (superior and temporal) macular thickness measurements were significantly higher in Group 2 at month 3 (P < 0.05). Foveal volume was also significantly higher in Group 2 when compared with Group 1 (P < 0.05). In Group 2, two eyes (10%) were diagnosed with clinically significant cystoid macular edema at the 1-month visit.ConclusionMacular thickness was found to be significantly high in eyes undergoing complicated cataract surgery (with posterior capsular tear) when compared with uneventful cataract surgeries of fellow eyes.

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Prognostic Factors that Determine Visual Outcome following Cataract Surgery Complicated by Vitreous Loss

Abstract: Poor visual outcome was associated with poor preoperative vision, age-related macular degeneration, cystoid macular edema, and secondary PPV following nuclear fragment loss. Primary PPV for nuclear fragment loss was not a significant association.

Cited by 9 publications

References 16 publications

Spectral-domain optical coherence tomography evaluation of postoperative cystoid macular oedema following phacoemulsification with intraoperative complication

Spectral-domain optical coherence tomography evaluation of postoperative cystoid macular oedema following phacoemulsification with intraoperative complication

Meta-analysis comparing same-day versus delayedvitrectomy clinical outcomes for intravitreal retained lens fragments after age-relatedcataract surgery

Quantitative analysis of macular thickness following uneventful and complicated cataract surgery

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Prognostic Factors that Determine Visual Outcome following Cataract Surgery Complicated by Vitreous Loss

Abstract: Poor visual outcome was associated with poor preoperative vision, age-related macular degeneration, cystoid macular edema, and secondary PPV following nuclear fragment loss. Primary PPV for nuclear fragment loss was not a significant association.

Cited by 9 publications

References 16 publications

Spectral-domain optical coherence tomography evaluation of postoperative cystoid macular oedema following phacoemulsification with intraoperative complication

Spectral-domain optical coherence tomography evaluation of postoperative cystoid macular oedema following phacoemulsification with intraoperative complication

Meta-analysis comparing same-day versus delayedvitrectomy clinical outcomes for&nbsp;intravitreal retained lens fragments after age-relatedcataract surgery

Quantitative analysis of macular thickness following uneventful and complicated cataract surgery

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Meta-analysis comparing same-day versus delayedvitrectomy clinical outcomes for intravitreal retained lens fragments after age-relatedcataract surgery