Posterior vitreous detachment rates post-uncomplicated phacoemulsification surgery: a systematic review
Daire J Hurley1, Patrick Murtagh2, Marc Guerin2
1Department of Ophthalmology, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, D07 R2WY, Ireland. dairehurley@gmail.com.
Insights
Phacoemulsification surgery accelerates posterior vitreous detachment (PVD) development, with 33.3% of patients experiencing PVD post-surgery. Careful pre-operative assessment and post-operative follow-up are recommended for patients without pre-existing PVD.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Vitreoretinal Interface
Background:
- Phacoemulsification is widely recognized as a risk factor for posterior vitreous detachment (PVD).
- This risk is particularly significant in younger patients without pre-existing PVD due to increased risks of retinal tears and detachments.
Purpose of the Study:
- To systematically review the incidence of PVD following uncomplicated phacoemulsification surgery.
- To analyze PVD occurrence based on time, patient age, gender, and axial length.
Main Methods:
- A comprehensive literature search was performed adhering to PRISMA guidelines.
- Seven studies, totaling 2034 eyes, met the inclusion criteria for analysis.
- Statistical analysis was conducted using Review Manager.
Main Results:
- A mean follow-up of 28.3 months was observed across the included studies.
- Posterior vitreous detachment (PVD) occurred in 33.3% of patients, with incidence increasing over time.
- No significant differences in PVD rates were found based on age, gender, or axial length.
Conclusions:
- Uncomplicated phacoemulsification surgery accelerates the natural progression of posterior vitreous detachment (PVD).
- Pre-operative evaluation of the vitreoretinal interface is crucial.
- Close post-operative monitoring is advised for patients without pre-existing PVD.
Purpose:
It is commonly accepted that phacoemulsification surgery is a risk factor for the development of posterior vitreous detachment (PVD) and may accelerate the process. This is an important consideration particularly in cases involving young patients who pre-operatively have no PVD, given the increased risk of retinal tears and detachments.
Methods:
A comprehensive literature search was conducted to identify studies reporting incidence of PVD post-uncomplicated phacoemulsification surgery. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was used for search strategy. Of 3071 titles, 7 studies met the inclusion criteria; The outcomes measured were PVD occurrence by (1) time, (2) type, (3) age, (4) gender and (5) axial length, with all statistical analysis performed using Review Manager.
Results:
A total of 2034 eyes were included for analysis with a mean follow-up time of 28.3 months. 33.3% of patients developed a PVD, either partial or complete, with rates increasing in a time dependent manner. No significant difference was noted in sub-group analysis by age, gender or axial length.
Conclusions:
The results from our systematic review show that uncomplicated phacoemulsification accelerates the physiological process of PVD development. Pre-operative evaluation of the vitreoretinal interface should be performed with careful post-operative follow-up advised in those without a pre-existing PVD.
