Time Course of Development of Posterior Vitreous Detachments after Phacoemulsification Surgery

Abstract

To determine when posterior vitreous detachments (PVDs) develop after phacoemulsification and aspiration combined with foldable intraocular lens implantation. Prospective, consecutive case series. A total of 575 eyes without a PVD preoperatively were studied prospectively and followed for 3 years after uneventful phacoemulsification surgery. All patients underwent a comprehensive ocular examination, including a dynamic vitreous examination using biomicroscopy with and without a preset lens and a preoperative retinal examination on the day of surgery; the day postoperatively; 1 week and 1, 3, 6, and 12 months postoperatively; and every 6 months for 3 years postoperatively. The patients were divided into groups and analyzed on the basis of age and refractive error or axial length. The cumulative incidence rates of eyes that developed PVD for 3 years postoperatively at each postoperative time point. The cumulative numbers and percentages of eyes that developed a PVD were 6 (1.0%), 18 (3.1%), 31 (5.4%), 45 (7.8%), 63 (11.0%), 88 (15.3%), 106 (18.4%), 133 (23.1%), and 172 (30.0%) within 1 week and 1, 3, 6, 12, 18, 24, 30, and 36 months, respectively. Eleven (6.4%) of the 172 eyes in which a PVD developed during the follow-up period had new retinal breaks with or without a retinal detachment. Eight (15.4%) of 52 eyes with lattice degeneration and 3 (2.5%) of 120 eyes without lattice degeneration had retinal breaks associated with a PVD; these percentages were significant (P = 0.003). Development of PVDs seems to accelerate after phacoemulsification and linearly accumulated for 3 years postoperatively. Approximately 6% of eyes with a PVD had retinal breaks and eyes with lattice degeneration had a 6.2-fold higher risk of developing retinal breaks associated with a PVD. Long-term follow-up is needed after phacoemulsification is performed.