EyeWorld Asia-Pacific December 2019 Issue

EWAP DECEMBER 2019 39 CATARACT is often detected with OCT and ultrasound after lens surgery in individuals without preoperative PVD – 71% after 3 months in nonmyopic eyes. 11 Pseudophakic eyes with an axial length of ĈÓx ÜiÀi ÃÜ Ì Li more likely to have a PVD as compared to those eyes with an axial length of <25 mm, odds ratio 4.7. 12 Higher percentages of new PVD after cataract surgery have been observed in younger patients and a trend towards higher occurrence of new PVD with increasing myopia was shown. 13 Ƃ``ÀiÃÃ} Ìi yÕiVi v PVD on RD after lens surgery in myopic eyes, Dr. Ullrich and her team are collecting data from 618 patients with axial lengths longer than 25 mm from 11 ophthalmology centers in six countries, as part of the Myopic Pseudophakic Retinal Detachment ESCRS Study. The study’s main outcome will be assessed in 3 years, with an extended follow-up to 5 years. The study includes funduscopy, SD-OCT, and ultrasound. Patients will be divided into two groups, complete PVD vs. partial or no PVD. The study is ongoing. “There are a number of clinical pearls to keep in mind. The presence of PVD should be assessed preoperatively, possibly with OCT. Prophylactic treatment with laser is controversial, however, it could be considered for example in an RD fellow eye with lattice. RLE in myopes, which requires an extensive informed consent procedure, might best be applied in patients over 55 years of age with PVD,” Dr. Ullrich said. EWAP References 1. Bjerrum SS, et al. Risk of pseudophakic retinal detachment in 202,226 patients using the fellow non-operated eye as reference. Ophthalmology . 2013;120:2573–2579. 2. Daien V, et al. Incidence, risk factors, and impact of age on retinal detachment after cataract surgery in France: a national population study. Ophthalmology . 2015;122:2179–85. 3. Rosen E. Risk management for rhegmatogenous retinal detachment following refractive lens exchange and phakic IOL implantation in myopic eyes. J Cataract Refract Surg . 2006;32:697–701. 4. Colin J, et al. Retinal detachment after clear lens extraction for high myopia: seven-year follow-up. Ophthalmology . 1999;106:2281–4. 5. Ripandelli G, et al. Cataract surgery as a risk factor for retinal detachment in very highly myopic eyes. Ophthalmology . 2003;110:2355–61. 6. Laube, T., et al., Pseudophakic retinal detachment in young-aged patients. PLoS One , 2017. 12(8): p. e0184187. 7. Tielsch, J.M., et al., Risk factors for retinal detachment after cataract surgery. A population-based case-control study. Ophthalmology , 1996. 103(10): p.1537-45. 8. Petousis V, et al. Risk factors for retinal detachment following cataract surgery: the impact of posterior capsule rupture. Br J Ophthalmol . 2016;100:1461–1465. 9. Yonemoto, J., et al., The age of onset of posterior vitreous detachment. Graefes Arch Clin Exp Ophthalmol , 1994. 232(2): p. 67-70. 10. Itakura, H., et al., Vitreous changes in high myopia observed by swept-source optical coherence tomography. Invest Ophthalmol Vis Sci , 2014. 55(3): p. 1447-52. 11. Ivastinovic D, et al. Evolution of early changes at the vitreoretinal interface after cataract surgery determined by optical coherence tomography and ultrasonography. Am J Ophthalmol . 2012;153:705–9. 12. Hilford, D., et al., Posterior vitreous detachment following cataract surgery. Eye (Lond) , 2009. 23(6): p. 1388-92. 13. Hikichi, T., Time course of development of posterior vitreous `iÌ>ViÌÃ >vÌiÀ «>ViÕÃwV>Ì surgery. Ophthalmology , 2012. 119(10): p. 2102-7. Editors’ note: Dr. Ullrich is a specialist at the Vienna Institute for Research in Ocular Surgery, Hanusch Hospital, Vienna, Austria, and declared no TGNGXCPV ƂPCPEKCN KPVGTGUVU Joinus in Singapore! 9 – 11 July 2020 • Suntec Singapore Convention Centre www.apacrs-snec2020.org