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Vitrectomy for macular hole associated with rapid nuclear cataract progression
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Nuclear sclerotic cataract density progressed more rapidly in eyes with macular hole that underwent vitrectomy and gas tamponade than in those that were merely observed, a study found.
“Our study suggests that nuclear cataracts that develop rapidly after vitrectomy plus gas tamponade offer an alternative and accelerated quantifiable disease model with Scheimpflug densitometry for future cataractogenesis treatment studies,” the study authors said.
The prospective, masked clinical trial included 98 patients with full-thickness macular hole participating in the Moorfields Macular Hole Study who were randomized to undergo pars plana vitrectomy with gas tamponade or observation.
Scheimpflug imaging of the crystalline lens was performed to evaluate nuclear sclerosis progression at baseline and 3, 6, 9 and 12 months after surgery.
Study results showed that nuclear density increased in vitrectomy patients by 16.6% at 3 months and 33.9% at 6 months; the increases over baseline were statistically significant (P < .0001).
The increase in nuclear density from baseline was 24 times greater in the vitrectomy group than in the observation group at 6 months postop (P < .0001).
Nuclear density increased by 1.4% from baseline to 6 months among patients in the observation group; the increase was not statistically significant.
Data showed a weak association between age and rate of nuclear sclerosis progression, the authors said.
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J Cataract Refract Surg. 2012;38(7):1176-1180.
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