gms | German Medical Science

Aim: To objectively investigate the progression of lens nuclear sclerosis after lens spearing pars plana vitrectomy (PPV) with silicon oil and gas, in patients with proliferative diabetic retinopathy (PDRP) and a head-to-head comparison with non-diabetic patients treated also treated with vitrectomy (siliconoil and gas).

Methods: Comparison of Pentacam HR^® Scheimpflug imaging-based lens densitometry of eyes with PDRP-associated tractive retinal detachment (Group 1) and nondiabetic eyes with rhegmatogenous retinal detachment (Group 2) after lens-sparing PPV.

Results: 103 eyes of 97 patients with a mean follow-up of 325.19 days were reviewed. In Group 1, age and baseline lens density (LD) only influenced LD postoperative progression (p<.001, respectively), whereas in Group 2, age, baseline LD, tamponade and time after surgery had an effect on the postoperative LD (p<.001, respectively). The prediction model for postoperative LD development showed a more prominent LD increase in the eyes of Group 1 compared to Group 2. In Group 1, LD slightly increased in eyes treated with silicone oil tamponade (SOT) and not in eyes that underwent PPV with gas tamponade (GT). In Group 2, the LD increment was superior when SOT was used compared to GT.

Conclusions: The increase of lens nuclear sclerosis is more prominent in nondiabetic than PDRP eyes after lens-sparing vitrectomy. In PDRP eyes, the tamponade does not affect the progression of nuclear opacification. These findings confirm the hypothesis that ischemic diabetic retinopathy protects against nuclear cataracts following vitrectomy surgery.

The presentation will be held in German.