Influence Of Posterior Vitreous Detachment On Retinal Detachment After Lens Surgery In Myopic Eyes - 3-Year Results Of The Escrs Myopred Study

Published 2024 - 42nd Congress of the ESCRS

Reference: FP19.04 | Type: Free paper | DOI: 10.82333/vf9a-5316

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 assess the influence of the preoperative posterior vitreous detachment (PVD) status on the incidence of retinal detachment (RD) after lens surgery in myopic eyes over a period of 3 years.

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 included. Fellow eyes were additionally observed. Preoperatively and at each follow-up visit funduscopy and optical coherence tomography (OCT) were performed, at sites participating the substudy, also B-scan ultrasonography if the hyaloid was not visible on OCT. Patients with preexisting complete PVD had one follow-up visit 2 months postoperatively and telephone interviews after 1, 2 and 3 years; patients without had follow-up visits 2, 6 and 12 months after surgery and telephone interviews at 2 and 3 years. To identify relevant surgical procedures patients were invited to unscheduled visits or relevant surgical reports were sent for verification.

Results

Mean age was 64.8±9.9 years (range 23.4-92.4), 48.4% were female and 51.6% male (n=609). Median axial length was 26.1 mm (IQR 25.5-27.4, n=606) in the study eyes and 26.4 mm (IQR 25.6-27.7, n=368) in the eligible fellow eyes. During the 3 years of follow-up 13 RDs occurred, 8 in study eyes, 5 in eligible fellow eyes (n=939). The overall estimated cumulative incidence rate was 0.83% at 1 year, 1.31% at 2 years and 1.56% at 3 years. For eyes with complete PVD at baseline it was 0.22% at 1 year, 0.44% at 2 years and 0.44% at 3 years and for eyes with no or incomplete PVD 1.65%, 2.33% and 3.04%, respectively. Unadjusted the subdistribution hazard ratio was 5.62 (95% CI: 1.57-20.14, p=0.008), adjusted by age 4.12 (CI: 0.96-17.66, p=0.057).

Conclusions

The MYOPRED study prospectively describes the incidence of RD in relation to the preoperative PVD status after lens surgery in myopic eyes over the first 3 years and in the future over 5 years. Myopic eyes without a complete PVD before lens surgery had a significantly higher RD incidence during the first 3 postoperative years.