Surgery for post-vitrectomy cataract (Review)

Abstract

Background Cataract formation or acceleration can occur after intraocular surgery, especially following vitrectomy, a surgical technique for removing the vitreous used in the treatment of disorders that affect the posterior segment of the eye.The underlying problemthat led to vitrectomy may limit benefit from cataract surgery. Objectives The objective of this review was to evaluate benefits and adverse outcomes of surgery for post-vitrectomy cataract with respect to visual acuity, quality of life, and other outcomes. Search strategy We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2011, Issue 2), MEDLINE (January 1950 to April 2011), EMBASE (January 1980 to April 2011), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to April 2011), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrial.gov) and the Australian New Zealand Clinical Trials Registry (ANZCTR) (www.anzctr.org.au). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 19 April 2011. Selection criteria We planned to include randomized and quasi-randomized trials comparing cataract surgery with no surgery in adult patients who developed cataract following vitrectomy. Data collection and analysis Two authors screened the search results independently. No studies were eligible for inclusion in the review. Main results We found no randomized or quasi-randomized trials comparing cataract surgery with no cataract surgery for patients who developed cataracts following vitrectomy surgery. There is no evidence from randomized or quasi-randomized controlled trials on which to base clinical recommendations for surgery for post-vitrectomy cataract. There is a clear need for randomized controlled trials to address this evidence gap. Such trials should stratify participants by their age, the retinal disorder leading to vitrectomy, and the status of the pathologic process in the contralateral eye. Outcomes assessed in such trials may include gain of 8 or more letters vision on the Early Treatment Diabetic Retinopathy Study (ETDRS) scale, quality of life, and adverse events such as posterior capsular rupture. Both short-term (six months) and long-term (oneyear or two-years) outcomes should be examined.