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Progression of posterior vitreous detachment after cataract surgery

Abstract

Purpose

To compare the progression of posterior vitreous detachment (PVD) between eyes that underwent cataract surgery and eyes that did not undergo surgery in non-highly myopic patients.

Methods

One-hundred twenty-five eyes of 125 patients scheduled for phacoemulsification and 125 eyes of 125 age-matched patients who did not undergo surgery were enrolled. PVD status was evaluated using swept-source optical coherence tomography at 2 days (baseline), and 1, 3, 6, and 12 months postoperatively, and classified into five stages: 0 (no), 1 (paramacular), 2 (perifoveal), 3 (peripapillary), and 4 (complete). The PVD stage and incidence of progression to complete PVD were compared between groups.

Results

The mean PVD stage significantly progressed over the 12 months in the surgery group (P = 0.0004), but did not change significantly in the non-surgery group. The PVD stage did not differ significantly between groups at 2 days, or 1, 3, and 6 months postoperatively, but was significantly more progressed in the surgery group than in the non-surgery group at 12 months (P = 0.0390). After adjusting for age, sex, axial length, and baseline PVD stage, the relative risk for progression to complete PVD was 7.1-fold higher in the surgery group than in the non-surgery group (P < 0.0001, 95% confidence interval 2.9–17.3).

Conclusion

PVD progressed significantly faster in eyes after cataract surgery compared with eyes that did not undergo surgery, and the relative risk of progression to complete PVD was approximately seven-fold higher within 1 year, indicating that the risk for PVD-related diseases is high after cataract surgery.

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Fig. 1: Comparison of the stage of posterior vitreous detachment (PVD) between eyes that underwent cataract surgery (surgery group) and eyes that did not undergo surgery (non-surgery group).
Fig. 2: Kaplan–Meyer survival analysis comparing the incidence of progression to complete posterior vitreous detachment (PVD) between eyes that underwent cataract surgery (surgery group) and eyes that did not undergo surgery (non-surgery group).
Fig. 3: Swept-source optical coherence tomography images of postoperative complications in eyes that underwent cataract surgery.
Fig. 4: Swept-source optical coherence tomography images of a representative eye among eyes that underwent cataract surgery (surgery group) and an eye that did not undergo surgery (non-surgery group).

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Acknowledgements

The authors thank Koji Yonemoto, PhD (Ryukyu University, Naha, Japan) for statistical assistance.

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Contributions

SH: study conception, study design, data analysis/interpretation of data, and writing and revising of the manuscript. MY: data acquisition and final approval. KH: study conception, study design, data acquisition, data analysis/interpretation of data, and writing and revising of the manuscript, and final approval. KT: study conception, study design, data analysis/interpretation of data, and final approval.

Corresponding author

Correspondence to Shunsuke Hayashi.

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Competing interests

The authors declare no competing interests.

Ethics approval

The Institutional Review Board of Hayashi Eye Hospital approved the study protocol.

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Hayashi, S., Yoshida, M., Hayashi, K. et al. Progression of posterior vitreous detachment after cataract surgery. Eye (2021). https://doi.org/10.1038/s41433-021-01732-6

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