ESCRS - FP19.03 - Development Of Posterior Vitreous Detachment After Lens Surgery In Myopic Eyes - 1-Year Results Of The Escrs Myopred Study

Development Of Posterior Vitreous Detachment After Lens Surgery In Myopic Eyes - 1-Year Results Of The Escrs Myopred Study

Published 2024 - 42nd Congress of the ESCRS

Reference: FP19.03 | Type: Free paper | DOI: 10.82333/ak13-zb61

Authors: Marlies Ullrich* 1 , Hannah Zwickl 1 , Caroline Pilwachs 1 , Álvaro Fernández-Vega Sanz 2 , Marie-José Tassignon 3 , Domagoj Ivastinovic 4 , Oliver Findl 1

1Vienna Institute for Research in Ocular Surgery (VIROS), Hanusch Hospital,Vienna,Austria, 2Instituto Oftalmológico Fernández-Vega,Oviedo,Spain, 3Department of Ophthalmology, Antwerp University Hospital, University of Antwerp,Antwerp,Belgium, 4Department of Ophthalmology, Medical University of Graz,Graz,Austria

Purpose

To document the preoperative posterior hyaloid attachment status and to evaluate the rate and time course of posterior vitreous detachment (PVD) induction and progression in myopic eyes without preexisting complete PVD within the first year after lens surgery (cataract surgery or refractive lens exchange).

Setting

Prospective multicenter study at 10 active European study centers: the European Society of Cataract and Refractive Surgeons (ESCRS) MYOpic Pseudophakic REtinal Detachment (MYOPRED) study

Methods

618 eyes of 618 patients with an axial length of ≥ 25.0 mm scheduled for lens surgery were recruited. Eyes with previous intraocular surgery, history of retinal detachment, trauma or uveitis were excluded. Fellow eyes that fulfilled the criteria of study eyes were additionally evaluated. Preoperatively and at each visit, funduscopy and optical coherence tomography (OCT) were performed. At sites participating the ultrasound substudy, patients also received B-scan ultrasonography if the hyaloid was not visible on OCT. All patients had a follow-up visit 2 months postoperatively, those without a preoperative complete PVD (no PVD, incomplete PVD, not decisive) additionally 6 months and 1 year after surgery or until presence of complete PVD.

Results

Of the patients, 48.4% were female and 51.6% male, mean age was 64.8±9.9 years (range 23.4-92.4; n=609). At baseline, PVD was complete in 53.8% of study eyes, incomplete in 25.8%; no PVD in 9.3% and not decisive in 11.0% (n=600), and in fellow eyes 51.4%, 27.4%, 7.9% and 13.3%, respectively (n=368). Of the eyes with no or incomplete PVD preoperatively, 9.9-12.6% developed a complete PVD by 2 months, 25.5% by 6 months and 40.2% by 12 months (study eyes + fellow eyes, n=328). The hazard ratio for progression to complete PVD was 1.37 (CI 1.10-1.69, p=0.003) for each decade of age and 1.25 (CI 1.11-1.54, p<0.001) for each mm of axial length. A progression of the PVD status occurred in 13.4%, 28.7% and 48.0% at 2, 6 and 12 months, respectively.

Conclusions

Within the first postoperative year after lens surgery, 40.2% of eyes with an axial length ≥ 25.0 mm without preexisting complete PVD (no/incomplete PVD) developed a complete PVD. 48.0% of eyes experienced a progression in the PVD status. The implications on the incidence of retinal detachment are further assessed and discussed in the 3-year and in the future 5-year analysis of the MYOPRED study.