Cataract Formation and Progression in Patients Less Than 50 Years of Age after Vitrectomy

Abstract

Purpose: To measure the rate of cataract development and progression of nuclear sclerotic cataracts (NSC), posterior subcapsular cataracts (PSC), and cortical spoking cataracts in nondiabetic patients <50 years of age after a pars plana vitrectomy.

Design: Retrospective cohort study.

Subjects: Twenty-six eyes of 26 patients <50 years of age that had undergone a pars plana vitrectomy were included.

Methods: Clinical records were reviewed retrospectively.

Main outcome measures: The NSC, PSC, and cortical spoking scores were recorded preoperatively and 1, 3, 6, 9, and 12 months after surgery until discharged from care, lost to follow-up, or last visit before cataract surgery. Eyes were graded on a scale of 0 to 4.0 using the lens opacities classification system LOCS II before and after pars plana vitrectomy for macular hole, epiretinal membranes, and vitreous hemorrhage. Linear regression analysis was performed to evaluate the rate of change in cataract score with elapsed time since surgery.

Results: The mean age at surgery was 30.6±14.3 years in 26 eyes with a median follow-up of 12 months. Eleven of 26 surgical eyes (42.3%) that had a baseline NSC and PSC score of zero in their surgical eye developed NSC, PSC, or both after vitrectomy. The mean progression for NSC, PSC, and cortical spoking were 0.327±0.14 (P = 0.032), 0.414±0.14 (P = 0.008), and 0.00±0.00 over a mean follow-up of 1.43 years, respectively. Linear regression analysis shows minimal increase in NSC (+0.09/year; P < 0.001; R² = +0.331), a slight increase in PSC (+0.16/year; P < 0.001; R² = +0.835), and a minimal decrease in cortical spoking (-0.02/year; P < 0.05; R² = -0.09).

Conclusions: Our findings suggest there is a minimal but significant increase in NSC and PSC scores for patients <50 years after pars plana vitrectomy. Cataract progression is not a significant factor in the first few years after vitrectomy in patients <50 years of age.