Progression of nuclear sclerosis based on changes in refractive values after lens-sparing vitrectomy in proliferative diabetic retinopathy

Abstract

BackgroundNuclear sclerosis (NS) based on the Emery–Little classification and refractive values after lens-sparing vitrectomy was compared between proliferative diabetic retinopathy (DR) patients and nondiabetic patients.MethodsProgression of NS based on the Emery–Little classification and changes in refractive values were compared between 13 proliferative DR patients (14 eyes, DR group) and 14 nondiabetic patients (14 eyes, non-DR group) who underwent lens-sparing vitrectomy. All patients revealed grade I NS based on the Emery–Little classification. Mean patient age and refractive value just after surgery were 56.07 years and −0.33 diopters (D) in the DR group, and 57.06 years and −0.96 D in the non-DR group.ResultsThe Emery–Little classification in the DR group at 6 and 24 months postoperative were grade I (13 eyes)/grade II (one eye) and grade I (eleven eyes)/grade II (three eyes), respectively. Mean refractive values in the DR group at 6, 12, and 24 months postoperative were +0.28 D, +0.27 D, and +0.37 D, respectively. The Emery–Little classification in the non-DR group at 6 and 24 months (or preoperative for patients undergoing cataract surgery) were grade I (five eyes)/grade II (eight eyes) and grade I (zero eyes)/grade II (eight eyes)/grade III (five eyes), respectively. The mean refractive value in the non-DR group at 6 months postoperative was −3.20 D. All eyes exhibited myopic changes and progression of NS.ConclusionThe findings of this study show that the progression of NS postvitrectomy is mild, even for DR patients 50 years of age or older, thus suggesting the need to reconsider the indications for simultaneous cataract surgery with vitrectomy.

Laminin α4 overexpression in the anterior lens capsule may contribute to the senescence of human lens epithelial cells in age-related cataract

“…Subsequently, the capsules were washed with PBS twice and stored at 80°C prior to protein extraction. All obtained ALCs were free from other ocular diseases and were graded for cataract severity using the Emery-Little Classification System of nuclear opacity grade before surgery [102,103]. Human cataractous ALCs were lysed using cold radioimmunoprecipitation assay (RIPA) buffer [50 mM Tris-HCl (pH 7.5), 150 mM NaCl, 1% Triton X-100 and 1% protease inhibitor cocktail from Sigma Aldrich; Merck KGaA, Darmstadt, Germany] overnight at 4˚C.…”

Refractive changes after lens-sparing vitrectomy for macular hole and epiretinal membrane

“…Vitreous surgery is used to treat many types of vitreoretinal diseases, and it is often performed in phakic, as well as aphakic and pseudophakic eyes. 3 Lens-sparing vitrectomy often results in postoperative formation of nuclear sclerotic cataracts. 4 – 8 Because nuclear sclerotic cataracts frequently affect refraction of the eye, shifting it toward myopic in the majority of cases, 9 , 10 symptoms of anisometropia should be carefully monitored after vitrectomy.…”

Comparison of Refractive Changes Following Pseudophakic Vitrectomy with or without Gas Tamponade

“…Also, 23 G, 25 G, and 27 G instrumentation were introduced with advances in technology since 1971 (Fujii et al, 2002;Eckardt, 2005;Oshima et al, 2010). Many reports have described the development of nuclear cataract and refractive changes following lens-sparing vitrectomy (Ikeda et al, 2014;Okamoto et al, 2014;Muto et al, 2017). Also, some reports have found changes in refraction toward myopia in pseudophakic eyes who underwent 20 G and 23 G vitrectomy for various vitreoretinal pathologies (Suzuki et al, 2000;Akinci et al, 2008).…”