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Yoshifumi Okamoto, Fumiki Okamoto, Takahiro Hiraoka, Tetsuro Oshika; Refractive Change after Lens-Sparing Pars Plana Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2314.
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To evaluate the refractive changes after lens-sparing vitrectomy for rhegmatogenous retinal detachment (RRD).
A retrospective chart review was conducted in 66 eyes of 66 patients (50.0±9.9 years old) who had undergone lens-sparing vitrectomy for RRD. Spherical equivalent refractive power was evaluated before, 1, 2, 3, 6, 9, 12, and 15 months after vitrectomy, and the time course of changes was evaluated. Other data collected included age, sex, ocular side, axial length, preoperative hemorrhage, preoperative spherical equivalent, operative time, size of retinal tear, logMAR best corrected visual acuity, the number of laser photocoagulation, the use of wide-angle viewing system, the use of intraoperative adjuvant and gas-tamponade, surgeon or the gauge of microincision viterectomy system, and postoperative vitreous hemorrhage and inflammatory reaction.
Significant and continuous myopic shift in refraction was observed in the operated eyes throughout the study period, and spherical equivalent was significantly different from the fellow control eyes after 3 months after lens-sparing vitrectomy (p < 0.05). Cataract surgery was performed in 27 eyes of 58 patients (47%) during the study period. When compared between the patients who received and did not receive cataract surgery during the follow up period, the former patients were significantly older (p < 0.05), but there was no significant difference in other all parameters such as operative time and the use of intraoperative adjuvant and gas-tamponade (p > 0.05).
There was a significant myopic progression in eyes after lens-sparing vitrectomy for RRD, causing considerable amount of anisometropia even in the early postoperative period. Patient age was only strong risk factor with the potential to progress the nuclear sclerotic cataract after lens-sparing vitrectomy.
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