Cataract surgery after vitrectomy: risks and benefits reflected by the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO)
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First Author: M.Dickman THE NETHERLANDS
Co Author(s): Y. Henry S. Manning P. Rosen M. Tassignon U. Stenevi M. Lundström
Cataract formation or acceleration can occur after intraocular surgery, especially following vitrectomy. The underlying posterior segment problem leading to vitrectomy could limit the benefit from cataract surgery and previous vitrectomy may increase the risk of compliations. The aim of this multintional registry study was to evaluate the practice patterns, benefits and risks of cataract surgery in eyes that develped cataract after vitrectomy.
multinational registry study using prospectively collected data from the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO).
Data reported to the EUREQUO between 2008 and 2018 was anonymized. To evaluate the incidence, effectiveness and safety of cataract surgery after vitrectomy, data on baseline characteristics, surgery and follow-up was analyzed and compated to non-vitrectomized eyes in the database. Univariate analyses used a t-test for continuous data and Chi-test for categorical data. Multivariate analyses were performed as stepwise logistic regression. Significance level was set at 0.05.
We identified 19416 cases after vitrectomy. Mean age was 64±10years (vs. 73.7±9.8 in the registry, p<0.001) and 52.5% male (vs. 41.9% in the registry, p<0.001). Preoperative BCVA was 0.61±0.65logMAR (vs. 0.37±0.27 non-vitrectomized eyes, p<0.001). The incidecne of cases after vitrectomy was stable around 1%. Incidence of surgical complications was 3.93% (vs. 2.39% in the registry).Postoperative BCVA≥LogMAR 0.3(0.5 Snellen) was achieved in 82.8% (vs. 95.6% in the registry, p<0.001). Biometry-prediction-error within 0.5D and 1.0D was achieved in 68.3% and 89.6% (vs. 72% and 92.9% in the registry, respectively, p<0.001). Postoperative complication were reported in 4.64% (vs. 1.96% in the registry).
We found patients undergoing cataract surgery after vitrectomy were younger and mostly male with fewer ocular comorbidities other then posterior segment disorders leading to vitrectomy. The incidence of cataract surgery after vitrectomy was stable. Adverse events were more frequent after vitrectomy and visual and refractive outcomes were slightly inferior compared to non-vitrectomized eyes, but most eyes gained vision and obtained good refractive outcome.