Early retinal changes after uncomplicated mild and hard cataract surgery

To evaluate and compare the possible effects of hard and soft nuclear cataract surgeries in the development of early postoperative retinal complications. In a retrospective study design 1388 uncomplicated phacoemulsification surgery were enrolled in the study. Data for 688 Grade 5-6 and 700 Grade 2-3 nuclear cataracts according to Lens Opacities Classification System III (LOCS III) were used for comparison. All patients were evaluated for visual acuity (VA), intraocular pressure (IOP), central macular pathologies and angiographic fluid leakage pattern at 1 week and 1 month. Biomicroscopic evaluation, optical coherence tomography (OCT), fleuroscein angiography (FA) and indocyanine green angiography (ICG) were used for examination. Follow up time was 1 month. Mean CMT of patients were higher at hard cataracts but not statistically significant (p>0.24). Clinically significant cystoid macular edema after hard nuclear cataract surgery was 1.59 %(11) and 1.28 %(9 ) for soft cataracts (p>0.05). After 20/20 visual acuity at 1 week, 5 (0.72 %) patients from hard nuclear group had visual loss and hemorrhagic pigment epitelial detachment (PED) at 1 month control. Angiographic evaluations revealed them 4 as insignificant polypoid choroidal vasculopathy (PCV). One of them is still controversial. IOP and VA results were similar at both controls (p> 0.05). Subretinal hemorrhage after cataract surgery may be the first sign of some PCV patients. Patients who were diagnosed with PCV should be carefully evaluated for cataract surgery. Hard nuclear cataract may be a predisposing factor for early hemorhagic PED in patients with PCV. Any retinal pathology should be carefully evaluted before cataract surgeries.

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