Nuclear sclerotic cataract after vitrectomy in patients younger than 50 years of age

Abstract

Purpose: To evaluate the occurrence of cataract formation after pars plana vitrectomy and gas-fluid exchange in patients younger than 50 years of age.

Methods: Twenty-eight patients younger than 50 years of age with bilaterally symmetric crystalline lenses underwent pars plana vitrectomy and gas-fluid exchange in one eye. Postoperatively, lens photographs were used to assess any asymmetry between the surgical and nonsurgical eye. Lens photographs were graded by three independent masked observers using the Lens Opacities Classification System III (LOCS III). Significant cataract progression was defined as either cataract extraction in the surgical eye or a greater than a 0.9 LOCS III unit difference in lens opacity between the surgical and nonsurgical eye. Results were compared with 28 patients older than 50 years of age who had undergone identical surgery.

Results: In only 7% of patients younger than 50 years of age (mean age, 36.5 years; range, 16-47 years) did significant lens opacity develop in the surgical eye compared with the nonsurgical eye during the follow-up period (mean follow-up, 25.4 months; range, 12-43 months). Of patients older than 50 years of age (mean age, 68.2 years; range, 51-85 years), 79% developed significant lens opacity in the surgical eye compared with the nonsurgical eye during the follow-up period (mean follow-up 27.3 months; range, 12-49 months). The difference in cataract progression between patients younger than 50 years of age and patients older than 50 years of age was statistically significant (P < 0.0000001).

Conclusion: Pars plana vitrectomy with gas-fluid exchange is minimally cataractogenic within the first few years in patients younger than 50 years of age.