Rate of posterior vitreous detachment appears to accelerate after phacoemulsification

This large prospective study found that posterior vitreous detachments (PVDs) developed in 30 percent of eyes three years after phacoemulsification. Furthermore, the rate of PVD accelerated between surgery and the end of follow-up.

A total of 575 eyes without a PVD preoperatively were followed for three years after uneventful phacoemulsification surgery and aspiration combined with foldable IOL implantation.

At one month, 3.1 percent of eyes developed PVD. This number increased to 5.4 percent at three months, 7.8 percent at six months, 11 percent at 12 months, 15.3 percent at 18 months, 18.4 percent at 24 months, 23.1 percent at 30 months, and 30 percent at 36 months.

About six percent of eyes with a PVD had new retinal breaks with or without a retinal detachment. Eyes with lattice degeneration had significantly higher risk for development of retinal breaks associated with PVD.

The authors comment that although the mechanism of acceleration of PVD development in eyes after cataract surgery is unclear, it may be due to the increased volume of the vitreous cavity postoperatively, which results in decreased density of the vitreous components, such as collagen and hyaluronic acid, and might induce instability of the vitreous gel and consequent development of a PVD.

They conclude that these findings are useful for managing eyes without a PVD after phacoemulsification. They note that in one previous study retinal detachment developed more than five years after surgery in 36 percent of cases and late-onset retinal detachments were not rare. Thus, longer follow-up is necessary after phacoemulsification surgery.