Assessment of nuclear sclerosis after nonvitrectomizing vitreous surgery

PURPOSE: Nuclear sclerosis develops frequently after successful pars plana vitrectomy. We evaluated changes in the degree of nuclear sclerosis after n onvitrectomizing vitreous surgery for idiopathic epimacular proliferation. METHODS: Forty,one consecutive patients (41 eyes) underwent removal of idio pathic epimacular proliferation by nonvitrectomizing vitreous surgery and w ere followed postoperatively for at least 12 months. Visual acuity, refract ive error, slit-lamp biomicroscopy, and Scheimpflug photographs were assess ed preoperatively and post, operatively to evaluate changes in the degree o f lenticular opacification. Quantitative analysis of the nuclear sclerosis was performed by densitometry with Scheimpflug photographs performed on onl y the last 21 patients. We evaluated these measurements by comparing statis tically the preoperative and postoperative difference between both eyes (op erative eye minus nonoperative ocular data). RESULTS: There was no significant difference in the progression of nuclear sclerosis or degree of myopic shift between the operated and fellow eyes du ring postoperative follow-up (mean +/- SD, 22 +/- 8 months; median, 22 mont hs; range, 12 to 48 months). The average preoperative and postoperative ref ractive errors in operated eyes were 0.0 +/- 2.4 diopters and 0.1 +/- 2.5 d iopters, respectively; the average difference in the refractive errors betw een both eyes was -0.2 +/- 0.7 diopter preoperatively and -0.2 +/- 0.9 diop ter postoperatively (P = .961, paired t test). The average preoperative and postoperative nuclear density values by Scheimpflug photography in 21 oper ated eyes were, respectively, 72 +/- 18 nuclear density units and 75 +/- 17 nuclear density units; the average difference in nuclear density values be tween both eyes was -1 +/- 4 nuclear density units preoperatively and 0 +/- 6 nuclear density units postoperatively (P = .631, paired t test). CONCLUSION: Progression of nuclear sclerotic cataract based on changes in r efractive error and Scheimpflug photography was not observed after nonvitre ctomizing vitreous surgery. (Am J Ophthalmol 2001;132: 356-362. (C) 2001 by Elsevier Science Inc. All rights reserved.).