Evolution of early changes at the vitreoretinal interface after cataract surgery determined by optical coherence tomography and ultrasonography

摘要

Purpose: To evaluate the onset of posterior vitreous detachment (PVD) including early changes at the vitreoretinal interface after uneventful phacoemulsification in nonmyopic eyes using optical coherence tomography (OCT) and ultrasound. Design: Prospective consecutive study. Methods: Patients undergoing cataract surgery at our unit between January and October 2010 were recruited and examined with OCT and ultrasound preoperatively. Inclusion criteria were complete vitreoretinal attachment, no ocular pathology other than cataract, and no previous ocular surgery. All patients underwent phacoemulsification with intraocular lens implantation. Postoperatively, OCT and ultrasound were performed 1 month and 3 months after surgery. Exclusion criteria were axial length ≥25 mm, lattice degeneration, intraoperative complications, and incomplete follow-up. Results: Forty-nine eyes of 49 patients could be enrolled in the study. Some degree of PVD was noted in 29 eyes (59.2%) 1 month after surgery and in 35 eyes (71.4%) 3 months after surgery. Moreover, a significant decrease in prevalence of initial PVD and a corresponding increase of more advanced PVD stages throughout the duration of the study was observed. In patients older than 70 years some degree of PVD was diagnosed in 92.3% compared to 47.8% in patients younger than 70 years (P =.002). Conclusion: OCT facilitates the detection of early vitreoretinal separation that indicates initial PVD. After phacoemulsification the prevalence of some degree of PVD is consequently more frequent when supplementary OCT is used. Furthermore, OCT discloses a significant progression of PVD in the postoperative course. Patients older than 70 years are more likely to develop pseudophakic PVD.