Cataract surgery outcomes and complications in vitrectomized vs non-vitrectomized eyes

Session Details

Session Title: Cataract
Session Date/Time: Saturday 16/02/2019 | 08:30-11:00
Paper Time: 10:24
Venue: Hall Trianti

First Author: D.Chiras UK
Co Author(s): N. Dervenis  P. Dervenis  S. Verma           

Abstract Details

Purpose:

To evaluate and compare the outcomes of cataract surgery in previously vitrectomized versus non-vitectomized eyes. To determine the risks and analyze the safety of phacoemulsification cataract surgery following vitrectomy.

Setting:

Moorfields Eye Hospital, London, UK.

Methods:

Retrospective, single surgeon firm, database study (case series). Data from consecutive patients undergoing cataract surgery between January 2015 and August 2017 was analyzed. Best corrected visual acuity, refractive outcomes and intraoperative and postoperative complications were compared between 149 vitrectomized eyes (prior PPV group) and 608 non-vitrectomized eyes (reference group).

Results:

Eyes following PPV had worse preoperative logMAR VA (0.75±0.54 vs. 0.40±0.33, P < 0.0001) than the reference group. Three weeks after surgery the mean logMAR VA was worse in the prior PPV group (0.15±0.29 vs. 0.09±0.22, P =0.014). No significant difference was observed for the postoperative refractive outcome between the two groups (p=0.393). The rate of posterior capsular rupture was not different between the two groups (p=0.223). A higher incidence of postoperative cystoid macular oedema (4% vs 1.5%, p=0.046) and posterior capsule opacification (6% vs 0.7%, p<0.0001) was observed in the vitrectomized eyes during follow up.

Conclusions:

Cataract surgery following vitrectomy with appropriate surgical technique modification was safe and effective and the refractive outcomes were similar compared to non-vitrectomised eyes. However, there was a worse mean postoperative visual acuity in vitrectomized eyes which was related with the pre-existing retinal pathology requiring vitrectomy. A close postoperative follow-up is recommended for vitrectomized eyes considering the higher incidence of cystoid macular oedema and posterior capsule opacification. Prospective studies including randomized controlled trials could help to analyze the relationship between previous vitrectomy and the development of cystoid macular oedema after cataract surgery and identify possible prophylactic options to reduce this risk.

Financial Disclosure:

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