J Korean Ophthalmol Soc.  2016 Nov;57(11):1745-1751. 10.3341/jkos.2016.57.11.1745.

Cataract Change after Vitrectomy and Gas Injection in Patients with Epiretinal Membrane and Macular Hole

• Ahn J
• Kim CR
• Kong M
• Han YS
• Chung IY
• Park JM

• KMID: 2357730
• DOI: http://doi.org/10.3341/jkos.2016.57.11.1745

Abstract

PURPOSE
To investigate the outcomes of quantitative lens nuclear opalescence change after pars plana vitrectomy and intravitreal gas injection in patients with idiopathic epiretinal membrane and macular hole.
METHODS
All patients were divided into two group according to the kinds of injected gases, either Group 1 (fluid/air exchange) or Group 2 (20% SF₆ gas injection). Lens nuclear opalescence according to the classification of Lens Opacities Classification System (LOCS) III, mean nuclear density and maximal nuclear density of Pentacam® scheimpflug image changed by image J, besides refractive errors were evaluated before surgery and 1, 2, 4, 6, and 12 months after surgery.
RESULTS
Out of 40 eyes of 40 patients included in the analysis, 21 received only fluid/air exchange (Group 1) and 19 received 20% SF₆ gas injection (Group 2). There were significant changes in lens nuclear opalescence between the study and control (unaffected) eyes. In both groups, the study eyes experienced significant progression of cataract compared with the control eyes, in terms of mean nuclear density, maximal nuclear density and LOCS III. In comparison according to the kinds of injected gases, there was a significant difference in mean nuclear density after 4 months, maximal nuclear density after 2 months and 4 months, LOCS after 2 months and 4 months, and refractive error after 1, 2, 4, and 6 months between both groups (p = 0.003).
CONCLUSIONS
After vitrectomy and intravitreal gas injection, changes in postoperative lens nuclear opalescence of the study eyes progressed more rapidly compared with the control eyes. This study identified that lens nuclear opalescence of Group 2 progressed rapidly, but after 12 months there was no significant difference of lens opacity between the kinds of injected gases.

Keyword

Cataract change; F/A exchange; Pentacam scheimpflug image; SF₆ gas injection; Vitrectomy

MeSH Terms

Cataract*
Classification
Epiretinal Membrane*
Gases
Humans
Iridescence
Refractive Errors
Retinal Perforations*
Vitrectomy*
Gases

Figure

• 

  Figure 1. Scheimpflug image of lens exported to ImageJ software for measuring the nuclear density in the region of interest. (A) Scheimpflug image on pentacam of preoperative cataract. (B) Same patient Scheimpflug image on pentacam of 12 months postoperative cataract.

• 

  Figure 2. Comparison of average cataract change between study eye and control eye over time. Figure (A-D) show average cataract change after vitrectomy of group 1. Figure (E-H) show average cataract change after vitrectomy of group 2. Cataract change was more rapid in study eyes than control eyes. Preop = preoperation; M = month(s). * p ＜ 0.05 compared with fellow eye.

Reference

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