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N. M. Holekamp, A. Almony, F. Bai, Y.-B. Shui, D. C. Beebe; Small Gauge Vitrectomy Does Not Protect Against Nuclear Sclerotic Cataract. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2959.
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To determine whether the gauge of vitrectomy instrumentation is associated with the progression of nuclear sclerotic cataract at 6 and 12 months after vitrectomy surgery. Specifically, we wanted to explore whether small gauge surgery is protective against the progression of nuclear sclerotic cataract.
Patients undergoing vitrectomy surgery for a variety of retinal conditions underwent Scheimpflug lens photography in the operated and fellow eye at baseline and at 6 and 12 months following vitrectomy surgery.
Of 42 eyes included in the analysis, 11 eyes had 20 gauge surgery, 22 had 23 gauge surgery, and 9 had 25 gauge surgery. In all operated eyes, vitrectomy surgery led to the significant progression of nuclear sclerotic cataract. There was no statistically significant difference in nuclear sclerotic progression when comparing small gauge surgery (23 and 25 gauge) to standard 20 gauge surgery. The fellow eyes did not develop nuclear sclerotic cataract. Adjusting for age and other co-morbidities did not alter these results.
In this study removal of the vitreous gel with infusion of balanced salt solution using any gauge vitrectomy surgery was found to lead to significant progression of nuclear sclerotic cataract at 6 and 12 months. The findings are consistent with the hypothesis that increased exposure to oxygen is responsible for nuclear cataract formation. This increased exposure to oxygen occurs as a result of the vitrectomy procedure and is independent of the gauge of vitrectomy instrumentation.
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