Duration of vitrectomy and postoperative cataract in the vitrectomy for macular hole study

- PURPOSE: To report the association between duration of vitrectomy, as wel l as other risk factors, and the progression of nuclear sclerosis and poste rior subcapsular cataract in the Vitrectomy for Macular Hole Study. - DESIGN: A cohort study nested within a randomized controlled clinical tri al. - METHODS: Using a system similar to the Lens Opacities Classification Syst em II, nuclear sclerosis (NS) and posterior subcapsular cataract (PSC) were scored in the vitrectomy and fellow eye of 74 patients at baseline and at 6, 12, and 24 months postoperatively. Age, baseline blood pressure and refr active power, and duration of surgery were evaluated as risk factors for NS or PSC progression and cataract extraction. - RESULTS: The incidence of NS progression in the surgical group of vitrect omy eyes was 81% at 6 months, 98% at 1 year, and 100% at 2 years of follow- up. In contrast, NS progression in the control group of fellow eyes was onl y 18% at 6 months, 20% at 1 year, and 8% at 2 years. The incidence of PSC p rogression in the surgical group remained at approximately 11% throughout f ollow,up, which was not significantly higher than the 3% to 5% incidence in the control group. Vitrectomy was significantly related to progression of NS cataract (P < .001) and cataract extraction (P < .01). No statistically significant differences were found for NS scores, PSC scores, or progressio n rates between eyes that had less than median surgical duration (60 min.) or more than the median surgical duration. Additionally, no significant dif ferences were found when eyes that experienced 45 minutes or less surgical duration were compared with eyes that endured more than 75 minutes surgical duration. Age, blood pressure, and refractive power were not found to be p redictors for NS and PSC progression. - CONCLUSIONS: Although vitrectomy is a risk factor for NS progression, the duration of vitrectomy does not increase the risk. (C) 2001 by Elsevier Sc ience Inc. All rights reserved.