Abstract
Purpose :
There is minimal documentation of the impact of cataract surgery on the vitreomacular interface in eyes with preexisting vitreomacular traction (VMT). There has been 1 descriptive case series on VMT progression after cataract surgery, but sample size was too small to draw any significant conclusions. This study evaluates the possible risk factors for progression of VMT after cataract surgery.
Methods :
Eyes with OCT-proven preoperative VMT that underwent cataract extraction from 2013-2020 and had at least 1-year follow-up postoperatively with OCT were analyzed. Primary outcome was OCT evidence of release or progression of VMT within 1 year of surgery. Other collected variables included patient characteristics, symptomatic release of VMT, and preoperative refractive error. Nonparametric Fischer Exact and Mann-Whitney U tests were used given smaller sample sizes. A p-value of <0.05 was considered statistically significant.
Results :
35 eyes with VMT from 30 patients met the above criteria. Of these, 5 eyes (14.29%) released within 1 year of cataract surgery. 8.6% spontaneously released and 5.7% released with vitrectomy for persistent symptomatic VMT. Of the patients that released, 2 patients (40%) had concurrent visual symptoms and 1 patient (20%) progressed to full thickness macular hole. The average number of days to progression or release was 151 days after cataract surgery.
41.7% of those who were myopic released, compared to 0% of those who were hyperopic (p = 0.003). Preoperative spherical equivalent was more myopic in eyes that released (-1.91 ± 1.36 diopters) compared to eyes that didn’t (+0.64 ± 1.74 diopters, p = 0.014). This also held true when spherical equivalents one year prior to cataract surgery were compared.
The average age among patients who released compared to those who did not release was similar at 74.57 years and 74.8 years respectively (p= 0.78). Sex between the two groups were also similarly distributed (p = 0.56).
Conclusions :
In eyes with preoperative VMT, the presence of myopia is a risk factor for VMT progression within 1 year after cataract extraction. Age at time of cataract extraction and sex of patient do not impact the rate of release. This suggests that myopic patients may require closer monitoring of VMT progression after cataract surgery.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.