Depending on pre-operative risk factors, about 30-50% of patients develop posterior vitreous detachment (PVD) after cataract surgery: which is a change in the vitreous protein behind the eye. It is not considered a complication PVDs occur in the majority of patients with normal aging. Symptoms of PVD include: floaters, flashes, sometimes a burst of floaters and flashes.

If the burst of floaters and flashes is sudden, persistent, and/or associated with a change of vision, worsening vision, or the “seeing” of a dark curtain coming over the vision, call your EYE MD emergently as it could signal that the vitreous protein change/PVD has pulled a piece of the retina off (as a hole or tear) and could potentially be leading to a retinal detachment which needs to be treated.

Sandra Lora Cremers, MD, FACS

2009 Jun;35(6):987-91. doi: 10.1016/j.jcrs.2009.02.016.

Incidence of posterior vitreous detachment after cataract surgery.

Mirshahi A1, Hoehn F, Lorenz K, Hattenbach LO.

Author information

Abstract

PURPOSE:

To report the incidence of posterior vitreous detachment (PVD) after uneventful state-of-the-art small-incision phacoemulsification with implantation of a posterior chamber intraocular lens (PC IOL).

SETTING:

Department of Ophthalmology, Ludwigshafen Hospital, Ludwigshafen, Germany.

METHODS:

This prospective study evaluated the vitreous status of eyes by biomicroscopic examination, indirect binocular ophthalmoscopy, and B-scan ultrasonography before planned cataract surgery. Patients with the posteriorvitreous attached were included for follow-up and examined 1 week, 1 month, and 1 year after uneventful phacoemulsification with PC IOL implantation. The preoperative prevalence and postoperative incidence of PVD were determined by ultrasonography.

RESULTS:

The study included 188 eyes of 188 patients (131 women, 57 men) with a mean age of 77.2 years. The mean spherical equivalent was -0.78 diopter (D) (range -8.75 to +6.25 D) and the mean axial length (AL), 23.22 mm (range 20.50 to 26.04 mm). Preoperatively, 130 eyes (69.1%) had PVD and 58 eyes (30.9%) had no PVD. Postoperatively, 12 eyes (20.7%) developed PVD at 1 week, 18 eyes (31%) at 1 month, and 4 eyes (6.9%) at 1 year. The vitreous body remained attached to the retina in 24 eyes (41.4%) 1 year after surgery. No preoperatively measured parameter (eg, age, refraction, AL, effective phacoemulsification time) was predictive of the occurrence of PVD after cataract surgery.

CONCLUSION:

The occurrence of PVD after modern cataract surgery was frequent in cases in which the posteriorhyaloid was attached to the retinal surface preoperatively.