Refractive change following pseudophakic vitrectomy

BMC Ophthalmol. 2008 Oct 13:8:19. doi: 10.1186/1471-2415-8-19.

Abstract

Background: To assess the occurrence and magnitude of refractive change in pseudophakic eyes undergoing 20 gauge pars plana vitrectomy without scleral buckling and to investigate possible aetiological factors.

Methods: Retrospective case note review of 87 pseudophakic eyes undergoing 20 gauge pars plana vitrectomy for a variety of vitreo-retinal conditions over a three-year period. Anterior chamber depth (ACD) was measured before and after vitrectomy surgery in 32 eyes. Forty-three pseudophakic fellow eyes were used as controls.

Results: Eighty-seven eyes (84 patients) were included in the study. Mean spherical equivalent refraction prior to vitrectomy was -0.20 dioptres, which changed to a mean of -0.65 dioptres postoperatively (standard deviation of refractive change 0.59, range-2.13 to 0.75 dioptres) (p < 0.001). Sixty-one of the 87(70%) eyes experienced a myopic shift and 45(52%) eyes had a myopic shift of -0.5 dioptres or more. Mean fellow eye refraction was -0.19 dioptres preoperatively and -0.17 dioptres postoperatively (p = 0.14)(n = 37)Mean ACD preoperatively was 3.29 mm and postoperatively 3.27 mm (p = 0.53) (n = 32) and there was no significant change in ACD with tamponade use. Regression analysis revealed no statistically significant association between changes in anterior chamber depth, as well as a wide variety of other pre-, intra and postoperative factors examined, and the refractive change observed.

Conclusion: Significant refractive changes occur in some pseudophakic patients undergoing 20 g pars plana vitrectomy. The mean change observed was a small myopic shift but the range was large. The aetiology of the refractive change is uncertain.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anterior Chamber / pathology
  • Eye Diseases / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myopia / etiology*
  • Myopia / physiopathology*
  • Postoperative Complications*
  • Pseudophakia / pathology
  • Pseudophakia / surgery*
  • Refraction, Ocular*
  • Retinal Diseases / surgery
  • Retrospective Studies
  • Vitrectomy*
  • Vitreous Body