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Ron A. Adelman, Hao Feng; Cataract Formation Following Vitreoretinal procedures. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6130.
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To evaluate the incidence and prevalence of cataract formation in patients who have undergone retinal procedures including scleral buckle, vitrectomy, and pneumatic retinopexy.
A retrospective review of the medical records of phakic patients at the Yale Eye Center who have undergone vitreoretinal surgery between January 2002 and December 2009 was conducted. Inclusion criteria include at least six months of follow-up and no prior intraocular surgery. The level of lens opacity was graded with a scale of 1+ to 4+. Patient demographics, pre-operative data, intra-operative factors, and post-operative information were recorded and analyzed.
192 eyes of 178 patients fulfilled the inclusion criteria with a mean age of 41.42 years. The percentage of patients that developed significant cataract requiring cataract extraction after retinal procedure was 49 % in 20 gauge vitrectomy, 42% in 23 and 25 gauge vitrectomy, 6% in scleral buckle, 7% in pneumatic retinopexy and 70% in combined vitrectomy and scleral buckle. In eyes undergoing 20 gauge vitrectomy, the cumulative percentage of eyes with cataract extraction was 5% in 1 month, 12% in 3 months, 17% in 6 months, 24% in 12 months, 39% in 24 months and 41% in 36 months. In eyes undergoing 23 and 25 gauge vitrectomy, the cumulative percentage of eyes with cataract extraction was 0% in 1 month, 4% in 3 months, 18% in 6 months, 36% in 12 months, 42% in 24 months and 42% in 36 months. In eyes undergoing combined vitrectomy and scleral buckle, the cumulative percentage of eyes with cataract extraction was 6% in 1 month, 12% in 3 months, 21% in 6 months, 52% in 12 months, 67% in 24 months and 70% in 36 months. The average amount of lens grading changes from pre-operative to the final examination were 1.7 for 20 gauge vitrectomy, 1.2 for 23 and 25 gauge vitrectomy, 0.5 for scleral buckle, 0.5 for pneumatic retinopexy and 2.1 for combined vitrectomy and scleral buckle.
There is no statistically significant difference in the degree of cataract formation/progression and percentage of eyes undergoing cataract extraction in patients who underwent standard 20 gauge versus the 23 or 25 gauge transconjunctival sutureless vitrectomy. Patients who underwent both vitrectomy and scleral buckle have a high risk of cataract formation following surgery, while those underwent scleral buckle or pneumatic retinopexy have a low risk of cataract formation.
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