Cataract progression in macular hole cases: results with vitrectomy or with observation

J Cataract Refract Surg. 2012 Jul;38(7):1176-80. doi: 10.1016/j.jcrs.2012.02.038.


Purpose: To quantify the difference in progression of nuclear sclerotic cataract using Scheimpflug image analysis in patients with idiopathic full-thickness macular hole who were randomized to have vitrectomy and gas tamponade or to be observed.

Setting: Moorfields Eye Hospital, London, United Kingdom.

Design: Prospective randomized placebo-controlled masked clinical trial.

Methods: As part of the Moorfields Macular Hole Study, patients with full-thickness macular hole who were randomized to have vitrectomy and gas tamponade or who were observed were compared. Patients had Scheimpflug image analysis of the crystalline lens to evaluate nuclear sclerosis progression by the single-masked observer at baseline and 3, 6, 9, and 12 months postoperatively.

Results: Ninety-eight patients had sufficient baseline data for analysis. At 3 months and 6 months, vitrectomy patients had significant increases in nuclear density compared with baseline (16.6% and 33.9%, respectively) (both P<.0001). In the observation group, nuclear density increased by 1.4% between baseline and 6 months (P = .92). At 6 months, the increase in nuclear density from baseline was 24 times greater in the surgical group than in the observation group (P<.0001). No correlation between the rate of nuclear sclerosis progression and age or baseline nuclear density was found.

Conclusions: Rapid nuclear sclerosis progression was quantifiable by Scheimpflug image analysis in patients having surgery for idiopathic full-thickness macular hole.There was no [corrected] evidence of a correlation between age groups and the rate of cataract progression.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cataract / physiopathology*
  • Disease Progression
  • Double-Blind Method
  • Endotamponade*
  • Female
  • Fluorocarbons / administration & dosage*
  • Humans
  • Lens, Crystalline / physiopathology
  • Male
  • Observation
  • Prospective Studies
  • Retinal Perforations / physiopathology*
  • Retinal Perforations / surgery*
  • Treatment Outcome
  • Visual Acuity / physiology
  • Vitrectomy*


  • Fluorocarbons
  • perflutren