Abstract
Purpose
To evaluate the baseline and post-vitrectomy lens densitometry values by a Scheimpflug camera in eyes with epiretinal membrane that were treated with 27-G microincision vitrectomy surgery (MIVS) without tamponade and to compare the results with those in fellow healthy eyes.
Patients and methods
Prospective case series. The lens densitometry measurements of 24 patients, who underwent 27-G MIVS without any tamponade for the treatment of epiretinal membrane, were taken preoperatively and on the first week, first month, and third month postoperatively with Pentacam HR-Scheimpflug imaging system.
Results
The mean lens densitometry values at Zone 1 and average lens densitometry values significantly increased in the study eyes on the first month when compared with the preoperative values (P=0.011, P=0.033, respectively). Additionally, there were statistically significant differences regarding the mean lens densitometry values of Zone 1 and Zone 2, and also average lens densitometry values between the preoperative and third month postoperative values (P=0.003, P=0.021, P=0.009, respectively). However, the densitometry values of fellow eyes were similar at preoperatively and all the postoperative follow-up periods (P>0.05 for all).
Conclusions
This study suggests that 27-G MIVS might cause post-surgical lens density changes even in early postoperative months and vitreous may play an important role in protecting the transparency of the lens.
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References
Oshima Y, Wakabayashi T, Sato T, Ohji M, Tano Y . A 27-gauge instrument system for transconjunctival sutureless microincision vitrectomy surgery. Ophthalmology 2010; 117: 93–102.
Lakhanpal RR, Humayun MS, de Juan E Jr, Lim JI, Chong LP, Chang TS et al. Outcomes of 140 consecutive cases of 25-gauge transconjunctival surgery for posterior segment disease. Ophthalmology 2005; 112: 817–824.
Fabian ID, Moisseiev J . Sutureless vitrectomy: evolution and current practices. Br J Ophthalmol 2011; 95: 318–324.
Khan MA, Shahlaee A, Toussaint B, Hsu J, Sivalingam A, Dugel PU et al. Outcomes of 27 gauge microincision vitrectomy surgery for posterior segment disease. Am J Ophthalmol 2016; 161: 36–43.
Tekin K, Sonmez K, Inanc M, Ozdemir K, Goker YS, Yilmazbas P . Evaluation of corneal topographic changes and surgically induced astigmatism after transconjunctival 27-gauge microincision vitrectomy surgery. Int Ophthalmol 2017. e-pub ahead of print 30 Mar 2017 doi:10.1007/s10792-017-0507-5.
Cherfan GM, Michels RG, de Bustros S, Enger C, Glaser BM . Nuclear sclerotic cataract after vitrectomy for idiopathic epiretinal membranes causing macular pucker. Am J Ophthalmol 1991; 111: 434–438.
Hsuan JD, Brown NA, Bron AJ, Patel CK, Rosen PH . Posterior subcapsular and nuclear cataract after vitrectomy. J Cataract Refract Surg 2001; 27: 437–444.
Panozzo G, Parolini B . Cataracts associated with posterior segment surgery. Ophthalmol Clin North Am 2004; 17: 557–568.
Rizzo S, Genovesi-Ebert F, Murri S, Belting C, Vento A, Cresti F et al. 25-gauge, sutureless vitrectomy and standart 20-gauge pars plana vitrectomy in idiopathic epiretinal membrane surgery: a comparative pilot study. Graefes Arch Clin Exp Ophthalmol 2006; 244: 472–479.
Feng H, Adelman RA . Cataract formation following vitreoretinal procedures. Clin Ophthalmol 2014; 8: 1957–1965.
Konstantopoulos A, Hossain P, Anderson DF . Recent advances in ophthalmic anterior segment imaging: a new era for ophthalmic diagnosis? Br J Ophthalmol 2007; 91: 551–557.
Belin MW, Ambrósio R . Scheimpflug imaging for keratoconus and ectatic disease. Indian J Ophthalmol 2013; 61: 401–406.
Piñero DP . Technologies for anatomical and geometric characterization of the corneal structure and anterior segment: a review. Semin Ophthalmol 2015; 30: 161–170.
Lim DH, Kim TH, Chung ES, Chung TY . Measurement of lens density using Scheimpflug imaging system as a screening test in the field of health examination for age-related cataract. Br J Ophthalmol 2015; 99: 184–191.
Grewal DS, Brar GS, Grewal SP . Correlation of nuclear cataract lens density using Scheimpflug images with Lens Opacities Classification System III and visual function. Ophthalmology 2009; 116: 1436–1443.
Kirkwood BJ, Hendicott PL, Read SA, Pesudovs K . Repeability and validity of lens densitometry measured with Scheimpflug imaging. J Cataract Refract Surg 2009; 35: 1210–1215.
Weiner X, Baumeister M, Kohnen T, Bühren J . Repeatability of lens densitometry using Scheimpflug imaging. J Cataract Refract Surg 2014; 40: 756–763.
Magalhães FP, Costa EF, Cariello AJ, Rodrigues EB, Hofling-Lima AL . Comparative analysis of the nuclear lens opalescence by the Lens Opacities Classification System III with nuclear density values provided by Oculus Pentacam: a cross-section study using Pentacam Nucleus Staging software. Arq Bras Oftalmol 2011; 74: 110–113.
Holekamp NM, Shui YB, Beebe DC . Vitrectomy surgery increases oxygen exposure to the lens: a possible mechanism for nuclear cataract formation. Am J Ophthalmol 2005; 139: 302–310.
de Bustros S, Thompson JT, Michels RG, Enger C, Rice TA, Glaser BM . Nuclear sclerosis after vitrectomy for idiopathic epiretinal membranes. Am J Ophthalmol 1988; 105: 160–164.
Ogura Y, Takanashi T, Ishigooka H, Ogino N . Quantitative analysis of lens changes after vitrectomy by fluorophotometry. Am J Ophthalmol 1991; 111: 179–183.
Thompson JT, Glaser BM, Sjaarda RN, Murphy RP . Progression of nuclear sclerosis and long-term visual results of vitrectomy with transforming growth factor beta-2 for macular holes. Am J Ophthalmol 1995; 119: 48–54.
Cheng L, Azen SP, El-Bradey MH, Scholz BM, Chaidhawangul S, Toyoguchi M . Duration of vitrectomy and postoperative cataract in the vitrectomy for macular hole study. Am J Ophthalmol 2001; 132: 881–887.
Michael R . Development and repair of cataract induced by ultraviolet radiation. Ophthalmic Res 2000; 32: 1–44.
Taylor HR, West SK, Rosenthan FS, Muñoz B, Newland HS, Abbey H et al. Effect of ultraviolet radiation on cataract formation. N Engl J Med 1989; 319: 1429–1433.
Saito Y, Lewis JM, Park I, Ikuno Y, Hayashi A, Ohji M et al. Nonvitrectomy vitreous surgery: a strategy to prevent postoperative nuclear sclerosis. Ophthalmology 1999; 106: 1541–1545.
Sawa M, Saito Y, Hayashi A, Kusaka S, Ohji M, Tano Y . Assessment of nuclear sclerosis after nonvitrectoming vitreous surgery. Am J Ophthalmol 2001; 132: 356–362.
Eaton JW . Is the lens canned? Free Radic Biol Med 1991; 11: 207–213.
Holekamp NM, Shui YB, Beebe D . Lower intraocular oxygen tension in diabetic patients: possible contribution to decreased incidence of nuclear sclerotic cataract. Am J Ophthalmol 2006; 141: 1027–1032.
Holekamp NM, Bai F, Shui YB, Almony A, Beebe DC . Ischemic diabetic retinopathy may protect against nuclear sclerotic cataract. Am J Ophthalmol 2010; 150: 543–550.
Shui YB, Holekamp NM, Kramer BC, Crowley JR, Wilkins MA, Chu F et al. The gel state of the vitreous and ascorbate-dependent oxygen consumption: relationship to the etiology of nuclear cataracts. Arch Ophthalmol 2009; 127: 475–482.
Almony A, Holekamp NM, Bai F, Shui YB, Beebe D . Small-gauge vitrectomy does not protect against nuclear sclerotic cataract. Retina 2012; 32: 499–505.
Chylack LT Jr, Leske C, McCarthy D, Khu P, Kashiwagi T, Sperduto R . Lens opacity classification system II (LOCS II). Arch Ophthalmol 1989; 107: 991–997.
Chylack LT Jr, Wolfe JK, Singer DM, Leske MC, Bullimore MA, Bailey IL et al. The Lens Opacities Classification System III. The Longitudinal Study of Cataract Study Group. Arch Ophthalmol 1993; 111: 831–836.
Vivino MA, Chintalagiri S, Trus B . Development of a Scheimpflug slit lamp camera system for quantitative densitometric analysis. Eye (Lond) 1993; 7: 791–798.
Datiles MB, Magno BV, Freidlin V . Study of nuclear cataract progression using the National Eye Institute Scheimpflug system. Br J Ophthalmol 1995; 79: 527–534.
Thompson JT . The role of patient age and intraocular gases in cataract progression following vitrectomy for macular holes and epiretinal membranes. Trans Am Ophthalmol Soc 2003; 101: 485–498.
Melberg NS, Thomas MA . Nuclear sclerotic cataract after vitrectomy in patients younger than 50 years of age. Ophthalmology 1995; 102: 1466–1471.
Ibáñez-Ruiz MA, Beneyto-Martin P, Pérez-MartÃnez MT . Lens density measurement with Scheimpflug camera in vitrectomised eyes. Arch Soc Esp Oftalmol 2016; 91: 385–390.
Acknowledgements
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. We would like to thank Dr Onder Aydemir from the Department of Public Health, Gazi University Faculty of Medicine for his assistance in the statistical analysis.
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Tekin, K., Inanc, M., Ozdemir, K. et al. The quantitative assessment of alterations in lens transparency after transconjunctival 27-gauge microincision vitrectomy surgery. Eye 32, 515–521 (2018). https://doi.org/10.1038/eye.2017.234
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DOI: https://doi.org/10.1038/eye.2017.234
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