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G. Clare, P. Sullivan, Z. Gregor, E. Ezra; Progression of Nuclear Sclerosis Following Vitrectomy and Gas Tamponade for Macular Hole . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4112.
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To report the rate of progression of crystalline lens nuclear sclerotic opacification following vitrectomy and gas tamponade for macular hole repair
98 patients undergoing elective surgery for a macular hole in one eye (46 left, 52 right) were recruited for this prospective study. Baseline (pre–operative) Scheimpflug densitometry analysis was performed. All patients had vitrectomy, internal limiting membrane peel and gas tamponade. Post–operative Scheimpflug measurements were carried out at three–monthly intervals until cataract surgery or up to one year
There was no significant difference in mean Scheimpflug lens densitometry readings between the eyes with a macular hole and their fellow eyes at baseline. At three months, however, the operated eyes showed a relative increase in lens densitometry of 10.5% compared to the fellow eye (n=90). This increased to 21.5% at 6 months (n=77) and 28.9% at 9 months (n=39). At 1 year, lens densitometry readings were 19.7% higher in operated eyes compared to fellow eyes (n=11). 87% of operated eyes measured at 3 months showed relative progression of density when compared to the unoperated eye. At 6 months this figure was 92%, 82% at 9 months and 73% at one year
Accelerated nuclear opacification occurs in eyes treated with vitrectomy and gas tamponade for macular hole repair. Our study shows that these eyes develop on average between 10% and 30% increases in nuclear density over the course of 1 year if they do not have cataract surgery first. The rate of change is highest in the first 9 months after macular hole repair, and tends to plateau thereafter. The rate of cataract development varies from eye to eye, with a minority of lenses showing no increased opacification even at one year
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