Nearly a third of eyes had intraocular pathologies after mature cataract surgery in this study.
Nearly a third of eyes had intraocular pathologies after mature cataract surgery in this study. Photo: Joseph W. Sowka, OD. Click image to enlarge.

In patients with dense media opacity, a detailed intraocular examination is only possible after extraction. However, the prevalence and risk of intraocular pathologies observed after mature cataract surgery haven’t been thoroughly documented. In a recent study, researchers reviewed the medical records of 115 patients with mature cataracts who underwent cataract surgery and evaluated the results of the postoperative fundus examinations.

Intraocular pathologies were observed in 32% of eyes after mature cataract surgery, with the most frequently observed abnormalities being drusen, myopic degeneration and diabetic retinopathy.

Previous studies have indicated limited posterior segment pathologies, including retinal detachment, post staphyloma and vitreous hemorrhage using ultrasonography. This study reported a higher detection rate, indicating that postoperative direct fundus examination is more accurate than preoperative ultrasound, given the value of direct observation. Although there was a significant difference between the two techniques, the authors explained that this doesn’t diminish the clinical implication of pre-op ultrasonography. 

“This is because, even though the frequency is small, it is possible to detect diseases with great clinical significance, such as one case of retinal detachment found in this study, using ultrasonography,” the authors explained.

They noted that 73% of affected patients had the same abnormalities in the fellow eye, most likely because most posterior segment pathologies identified usually appear in both eyes.

The prevalence of each posterior segment pathology was unremarkable compared with the overall prevalence of the same pathology among similar age groups in previous studies, suggesting mature cataracts are an independent factor of intraocular pathologies described in this study.

“However, although this was not addressed in this study, the detection of posterior segment pathologies could be delayed due to dense cataracts,” the authors noted.

Kim MS, Moon JH, Lee MW, Cho KH. Analysis of postoperative intraocular pathologies in patients with mature cataracts. PLoS ONE. January 31, 2022. [Epub ahead of print].