Cataract Formation And Progression After Vitrectomy Surgery: A Targeted Literature Review
Published 2022
- 40th Congress of the ESCRS
Reference: PO431
| Type: ESCRS 2022 - Posters
| DOI:
10.82333/wjyr-m216
Authors:
Lawrence Woodard 1
, Carine Hsiao 2
, Richard Kara 2
, Wendy Zhi Wang 3
, Elizabeth Persaud 3
, Derek O'Boyle* 4
1Atlanta Eye Surgery Center,Atlanta,United States, 2Alcon Laboratories, Inc.,Fort Worth,United States, 3EVERSANA,Burlington,Canada, 4Alcon, Enniscrone,Ireland
Purpose
Patients who undergo vitrectomy may require a subsequent surgery to remove cataracts that develop or progress as a result of their initial procedure. A targeted literature review was conducted to characterize the burden of post-vitrectomy cataracts.
Methods
PubMed was searched in September 2021 using terms such as “vitrectomy and phacoemulsification” and “cataract progression” to identify observational or randomized studies of adult patients treated with sequential vitrectomy and cataract surgeries. The search was not restricted by publication date, study size, indication, or patient characteristics including cataract status at time of vitrectomy. English-language studies that reported the development or progression of cataracts after vitrectomy were included. Primary outcomes of interest included the incidence of post-vitrectomy cataract surgery, the time required for cataracts to progress to the point of needing surgery, and factors contributing to cataract progression.
Results
Fourteen studies were included (observational=12; randomized trial [RCT]=1; RCT post-hoc analysis=1). Vitrectomy may contribute to nuclear sclerosis and increased lens growth (n=4). The mean time between sequential surgeries ranged from 8.1–18.8 months (n=4) (median 9.4–11.5 months [n=2]). Cataracts formed within 2 years of vitrectomy in up to 100% of patients >50 years old (n=2) and in up to 34% of patients ≤50 years old (n=2). Older age and larger lenses were associated with nuclear sclerotic cataract progression (n=2) and younger age and non-diabetic retinal detachment were associated with posterior subcapsular cataract progression (n=3). Larger vitrectomy instruments may induce mild lens changes more frequently than small gauge (n=1).
Conclusions
Patient age, baseline lens densitometry, and the type of procedure performed may impact the progression of cataracts after vitrectomy. Older patients with existing nuclear sclerotic cataracts may be ideal candidates for simultaneous vitrectomy and cataract surgeries to avoid further cataract progression and additional surgery.