25–Gauge Transconjunctival Vitrectomy Safety: Cataract Progression

Abstract

Abstract: : Purpose: To evaluate the rate of postoperative cataract progression following 25–gauge transconjunctival vitrectomy surgery. Methods: A consecutive series of 209 eyes in 200 patients that underwent 25–gauge vitrectomy between April 2002 and October 2003 was studied prospectively. The severity of nuclear, cortical, and posterior subcapsular lens opacities was graded during slit lamp examination. The main outcome variable was cataract progression defined as any change in lens opacification grade. Results: Of the 209 eyes studied, 106 were phakic at the time of 25–gauge vitrectomy. However, 23 phakic eyes were excluded from this analysis based on previous vitreoretinal surgery or subsequent vitreoretinal surgery during the study period, yielding a total of 83 phakic eyes. Of these 83 phakic eyes undergoing 25–gauge vitrectomy, 21 (25%) had documented post–operative cataract progression. The mean follow–up was 12.5 months. Cataract extraction was performed on 13/106 (12.3%) eyes during the follow–up period. Conclusions: In this prospective series, 25–gauge vitrectomy resulted in a lower than expected rate of cataract progression with one–year follow–up. While this study lacks a prospective control group, post–operative cataract progression seems lower than reported rates with 20–gauge vitrectomy.

Keywords: cataract • clinical (human) or epidemiologic studies: outcomes/complications • retina