Comparison of Aqueous Depth Changes Following Cataract Surgery in Vitrectomized and Non-Vitrectomized Fellow Eyes

Background/Objectives: The role of the vitreous in the effective lens position (ELP) is controversial in patients undergoing phacovitrectomy. The aim of this study was to compare the change in aqueous depth (AD), a surrogate of the ELP, in non-vitrectomized and vitrectomized fellow eyes. Methods: Post-hoc analysis of a prospective study conducted in OMIQ facilities (Barcelona, Spain) between 2021 and 2023. Patients with bilateral cataracts and a unilateral grade 2/3 epiretinal membrane underwent phacoemulsification in one eye and phacovitrectomy without endotamponade in the fellow eye. All eyes were implanted with an extended depth-of-focus intraocular lens after power calculation using the same biometer, technicians, formula, and surgeon. We compared the change in AD (mm and percentage) from baseline, and the role of vitrectomy without endotamponade on AD with a mixed-effects models. Results: We included 40 eyes (20 patients) with a mean age of 71.6 years, with 55% females. The mean change in AD was +1.51 (vitrectomized) and +1.42 mm (non-vitrectomized eyes), p = 0.33. The percent of change in AD was not different between groups (p ≥ 0.38) and phacovitrectomy had no effect on the change in AD on mixed-effects models (p > 0.10). Conclusions: The absence of the vitreous had a minimal influence on AD in these patients undergoing standard phacoemulsification or phacovitrectomy.