A team looking into the prognostic factors associated with low visual acuity in patients experiencing vitreous loss during cataract surgery identified ocular comorbidities, secondary intraocular lens (IOL) implantation, cystoid macular edema development and additional surgical complications as playing a role.

The retrospective, noncomparative, interventional case study evaluated 179 patients experiencing vitreous loss during cataract surgery (60% male) with a mean age of 73 years, axial length of 23.5mm and follow-up of 12 months. The researchers assessed demographics, best-corrected visual acuity (BCVA), axial length, presence of ocular comorbidities affecting central vision, timing of IOL implantation, position of the implanted lens and presence of corneal sutures. Low visual outcome was defined as BCVA<20/40.

Multivariable logistic regression analysis discovered that low visual outcomes were independently associated with persisting postoperative complications (odds ratio [OR] 6.25), preexisting ocular comorbidities (OR 4.45) and secondary IOL implantation (OR 10.36). Conversely, pars plana vitrectomy for dislocated fragments of lens material, age older than 70, gender, axial length, degree of surgeon, corneal suturing and anterior chamber lens implantation were not found to have significant associations with low visual outcomes.

Eye doctors, specifically those involved in delivery of cataract surgery and its follow-up care, “should be aware of these findings in order to give their patients more accurate prognosis,” the study authors concluded in their paper.

Mimouni M, Schaap-Fogler M, Polkinghorne P, et al. Prognostic factors for low visual acuity after cataract surgery with vitreous loss. J Ophthalmol. 2021;2021:6691904.