Cataract Following Pars Plana Vitrectomy: A Review

Area of Science:

• Ophthalmology
• Ocular Surgery
• Lens Physiology

Background:

• Pars plana vitrectomy (PPV) indications have expanded, revealing the vitreous's crucial role beyond an inert structure.
• Vitreous removal impacts ocular anatomy and physiology, notably affecting intraocular oxygen regulation.
• The crystalline lens requires protection from oxygen to maintain transparency; PPV can disrupt this balance, accelerating nuclear sclerosis.

Purpose of the Study:

• To systematically review the literature on cataract formation and surgical management following pars plana vitrectomy.
• To elucidate the physiological consequences of vitreous removal on lens clarity and surgical outcomes.

Main Methods:

• A systematic literature review was performed using Embase and Medline databases.
• Included articles focused on the physiology, pathogenesis, and surgical treatment of cataracts post-PPV.

Main Results:

• The exact pathogenesis of post-PPV cataract remains unclear.
• Identified predisposing factors include patient age, pre-existing cataracts, light toxicity, intraoperative oxidation, use of silicone oil or gas, mechanical trauma, and irrigation duration.

Conclusions:

• Cataract surgery in vitrectomized eyes is technically more demanding and associated with increased intraoperative and postoperative complication risks.
• Current management lacks standardization, necessitating heightened surgical precautions for these complex cases.