Is more always better in cataract surgery?

Abstract

magnitude and direction of vector forces during eye rotations. The usual chronic course of AMD with exacerbations and remissions and often progressive, bilateral appearance are suggestive of intermittent traumatic effects. Physiological vitreous changes and eye rotations occur in everyone, but vitreous structures will only touch the retina in the presence of elongated cisterns and ⁄or significant vitreous movements, which process might be facilitated by vitreomacular adhesions. Our hypothesis that mechanical stress might contribute to the pathogenesis of AMD is supported by the clinical findings of others, who used spectral domain optical coherence tomography to evaluate the vitreoretinal interface: a positive relationship between a persistent attachment of the posterior vitreous and early signs of AMD was found (Schulze et al. 2012) as well as a complete correspondence between the adhesion and subretinal neovascularization (Krebs et al. 2011). We realize that observational and anatomical, experimental studies have their limitations, and further histopathological as well as case–control studies are required to confirm our hypothesis. We thank Peter J. de Lint, vitreoretinal surgeon in the Medical Center Alkmaar; the Corneal Eye Bank, Amsterdam; the Jan Worst Research Group, Haren; the ophthalmic photography units of the VU University Medical Center, Amsterdam; and theMedical Center Alkmaar, the Netherlands.