Examination of Vitreolenticular Interface in Relation to Different Phacoemulsification Parameters in Early and Late Postoperative Period

TL;DR

This study examines how surgical parameters during cataract surgery affect the vitreolenticular interface over time.

Contribution

The study identifies specific surgical parameters that are risk factors for anterior vitreous detachment after phacoemulsification.

Findings

Zonular weakness and high cumulative dissipated energy are significant risk factors for anterior vitreous detachment.

High nuclear sclerosis grades and high fluid usage correlate with anterior vitreous detachment at multiple postoperative times.

Presence of lens materials in Berger’s space correlates with zonular weakness and higher fluid usage.

Abstract

Background: The surgical parameters of phacoemulsification can significantly impact the behavior of the anterior hyaloid membrane (AHM). Methods: In this prospective study, anterior segment optical coherence tomography was used to examine the attachment or detachment of the AHM of 82 eyes after uneventful phacoemulsification preoperatively and postoperatively over 1 year. The impacts of the capsulorhexis’ size, number of hydrodissections, nuclear sclerosis grade, cumulative dissipated energy (CDE), ultrasonic time, total surgical time, weakness of zonular fibers, presence of lens materials in Berger’s space (LM-BS), and fluid usage were investigated in relation to the behavior of the AHM. Results: A significant linear trend regarding anterior vitreous detachment (AVD) was observed in the presence of zonular weakness and high CDE at all postoperative times (p ≤ 0.024 and p ≤ 0.005, respectively). Similarly, AVD was observed at 1-month, 3-month, and 1-year follow-ups in cases of high nuclear sclerosis grades (p ≤ 0.044) and high fluid usage (p ≤ 0.021). A significant correlation was observed in the group of LM-BS as the zonular weakness value increased (OR: 0.085; 95% CI: 0.017 to 0.420; p = 0.002), and the fluid usage was also significantly higher (OR: 1.049; 95% CI: 1.003–1.096; p = 0.037). Conclusions: Zonular weakness, high CDE, a hard nucleus, and high fluid usage are risk factors for postoperative AVD.

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