One of the potential complications of vitrectomy is the formation of a cataract, particularly in people ages 50 and older.

Vitrectomy is a surgical procedure that drains your eye’s vitreous fluid, often to better reach and repair the retina in the case of retinal detachment, to treat lesions on the macula, or to remove scar tissue.

Cataracts can only be fully treated through cataract surgery, which replaces the cloudy lens with an artificial intraocular lens (IOL). It is possible to have a cataract surgery after vitrectomy if precautions are taken.

Cataract surgery is more delicate and requires special attention after vitrectomy. There are additional possible risk factors. Talk to your doctor about the risks and benefits of cataract surgery if you have had vitrectomy.

Cataracts After Vitrectomywoman with cataract

You can have cataract surgery after vitrectomy. Your doctor will just have to take special precautions, and there are some additional postoperative complications to keep in mind.

Cataracts most commonly form due to age as the proteins in the eye break down, start to clump, and lead to clouding of the lens. Other factors can be involved in the formation of cataracts too, such as trauma to the eye and intraocular surgery such as vitrectomy.

Vitrectomy is a surgical procedure that removes vitreous fluid from the eye to get better access to the retina. This is done for a variety of reasons, including:

  • To address retinal detachment.
  • To remove scar tissue or a foreign object from the eye.
  • To repair macular lesions.
  • To remove blood.

The incidence for formation or progression of nuclear sclerotic cataracts is increased with vitrectomy. This is a safe and effective procedure, but it does lead to eye trauma that can raise the risk for cataracts. Treatment for this often includes surgery as well.

When Can You Have Cataract Surgery After Vitrectomy?

There is not a specific amount of time you should wait to have cataract surgery after undergoing vitrectomy.

The American Academy of Ophthalmology (AAO) recommends giving your eyes at least three months to heal from one eye surgery before committing to a second operation. You can then be sure that the swelling has gone down, the eye has completely healed, and the issues necessitating the initial surgery are resolved before having cataract surgery.

Complications After Vitrectomy

If you have had vitrectomy, the fluid in your eye has been changed. Saline is not as stable as vitreous fluid when it comes to holding up a new replacement lens used in cataract surgery, the IOL.

Vitrectomy surgery can also make your anterior chamber of the eye deeper and therefore less supportive for the new lens during and after surgery. Surgical techniques will need to be modified to account for this.

It can be difficult for an eye doctor to determine the right prescription for the IOL, as it is tricky to measure exactly where the lens is going to sit after surgery. The doctor will need to use specialized tools, such as a slit lamp and often an ultrasound machine, to ensure that there are no defects in the posterior capsule. These tools enable them to get an accurate reading on where the IOL will end up resting.

The IOL is likely to sit further back in an eye that has had vitrectomy, which can cause mild myopia (nearsightedness). A higher powered IOL is often needed to correct this problem.

During cataract surgery, the ophthalmologist may need to account for pressure changes related to vitrectomy and take special care to ensure the success of the operation.

Postoperative Cataract Surgery Risk Factors Following Vitrectomy

Cataract surgery can be effective and successful after vitrectomy when considerations are made during the operation and close watch is taken postoperatively. Having cataract surgery after vitrectomy does increase potential complications and risk factors, depending on why the vitrectomy procedure was performed.

If vitrectomy was done to fix macular problems, cataract surgery can raise the risk for cystoid macular edema. You will need to be monitored closely and take anti-inflammatory medications for a longer period of time when this is the case.

If vitrectomy was performed to repair a detached retina, there is a greater chance of a future recurrent retinal detachment after cataract surgery. In this case, your retina will need to be checked often. It can take longer for your eyes to heal after cataract surgery than the traditional timeline of a few weeks.

It can also be harder for your eyes to maintain a stable refraction after cataract surgery following vitrectomy. You will need to update prescriptions for your eyewear more frequently to keep up with the changes.

Talk to your doctor about the safety and potential prognosis for your cataract surgery after vitrectomy. Typically, it is best to wait until cataracts are interfering with your daily life before having them surgically removed.

References

What Are Vitrectomy Surgery Risks? (April 2020). American Academy of Ophthalmology (AAO).

What Are Cataracts? (October 2020). American Academy of Ophthalmology (AAO).

Surgery for Post-Vitrectomy Cataract. (December 2013). Cochrane Database System Review.

Cataract Surgery Can Be More Challenging After Vitrectomy. (October 2010). Ocular Surgery News.

What Is a Safe Waiting Period to Have Cataract Surgery After a Vitrectomy for a Detached Retina? (July 2014). American Academy of Ophthalmology (AAO).

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