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Study investigates impact of preop PVD on RD rate after lens surgery in myopic eyes

Issue: February 2017

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MAASTRICHT, Netherlands — MyopReD, an ESCRS study, will look at the influence of posterior vitreous detachment before surgery on retinal detachment rate after lens surgery in myopic eyes.

“This is a multicenter study involving 10 sites in five countries in Europe. We are going to recruit 618 patients with [axial length of] 25 mm or longer, with main outcome at 3 and 5 years. Clinical slit lamp evaluation, OCT and [ultrasound] if needed will be used to define whether PVD is present,” Oliver Findl, MD, MBA, said at the European Society of Cataract and Refractive Surgeons winter meeting.

Oliver Findl

Data on retinal detachment rate after lens surgery are “a real jungle, in which you have to fight to try to get through,” he said. Myopia, and particularly high myopia over –10 D, is known to increase the risk due to the anatomical and biochemical changes produced by the operation.

“By replacing the thick crystalline lens with a thin IOL, we increase the posterior segment volume, and the forward motion of the anterior hyaloid exerts a dynamic traction on the vitreous base. There are also changes in vitreous composition, induced by the low inflammation and decrease in hyaluronic acid concentration that follows uncomplicated cataract surgery,” Findl said.

PVD is a rather common event after cataract surgery, occurring at least partially in about 60% of eyes within 1 month. PVD before surgery has a protective effect against RD after surgery, as shown in a study by Ripandelli and colleagues. Patients who already had PVD preoperatively had a 1.1% RD risk, as compared with 7.4% in those who did not have preoperative PVD.

The aim of the ESCRS study is to evaluate RD risk in myopic eyes, in which PVD occurs more frequently and at an earlier age as compared with emmetropic eyes. – by Michela Cimberle

Reference:

Findl O. Refractive lens exchange: As time goes by. European Society of Cataract and Refractive Surgeons winter meeting; Feb. 10-12, 2017; Maastricht, Netherlands.

Disclosure: Findl reports no relevant financial disclosures.