Lens densitometry for assessment and prediction of cataract progression after pars plana vitrectomy with C3F8-gas for retinal detachment

Abstract

Purpose Lens opacification is a common complication after pars plana vitrectomy (PPV) and knowing its progression would facilitate consulting patients. The purpose of this study was to evaluate a quantitative model for lens-status-monitoring after PPV with C3F8 gas. Our model was evaluated in rhegmatogenous retinal detachment (RRD) patients of various age and lens densitometry (LD). Methods Data between March 2018 and March 2020 were evaluated retrospectively. LD measurements of the PentacamHR® Nucleus Staging mode (PNS) were used to quantify lens opacification over time. A mixed-effect regression model was designed, to enable LD predictions at any time postoperatively. Calculations were based on patient’s age and baseline LD as dependent variables. Six patients were randomly excluded during model development, to be used for testing its power afterwards. Results 34 patients (male 19 [55.9%], female 15 [44.1%]) matched the inclusion criteria. Average age was 58.5 years (32–77;±4.3) and average follow-up was 7.2 months (3,4–23.1;±1,8). Mean baseline LD of the treated and fellow eye before surgery were 10.9% (8.7%-14.8%;±0.8) and 10.7% (8.5%-14.1%;±0.6), respectively. Using our prediction model, LD values for the six pre-selected patients closely match the observed data with an average deviation of 1.07%. Conclusions Evaluation of age and baseline LD using a mixed-effect regression model might predict cataract progression in RRD patients treated with PPV and C3F8-gas. Such a tool could be considered during cataract surgery consultation in these patients.

Predicting speed of progression of lens opacification after pars plana vitrectomy with silicone oil

“…This finding is supported when looking at the data of the average LD 6 months after surgery from our previous study on the progression of lens opacity after PPV with C3F8 gas. With silicone oil mean LD of the cohort increases by approximately 5.5%, whereas under C3F8 gas {(n = 34; age (years) 32-77; 58.5 (±4.3); baseline LD treated eye (%) 8.7-14.8; 10.9 (±0.8)} there was only an increase of about 2.7% within 6 months after PPV [10].…”

“…Only PentacamHR1 images without reflections or distortions were used for the evaluation. This method has been successfully established by prior various studies [10][11][12][13][14][15][16].…”

“…Web application for predicting postoperative lens densitometries. As we did for PPV with C3F8-gas previously [10], we provide a web application that calculates individual postoperative trajectories for LD based on the model shown above. Only "age" in years and "baseline LD" must be provided by the user and the application displays the results as a line plot.…”

“…It has already been shown for C3F8-gas that lens opacity after a PPV can be predicted for every point in time after surgery with sufficient accuracy by using lens densitometry with a mathematical model [10]. PPV nowadays is more and more often combined with cataract surgery in patients over 50 years of age, but it may also be considered in younger patients.…”