Limited progression of nuclear sclerosis after lens sparing vitrectomy in proliferative diabetic retinopathy eyes: a real-world investigation with Scheimpflug lens densitometry.

Background: To objectively investigate the progression of lens nuclear sclerosis after lens spearing pars plana vitrectomy (PPV) in patients with proliferative diabetic retinopathy (PDR).

Methods: Comparison of Pentacam HR® Scheimpflug imaging-based lens densitometry of eyes with PDR-associated tractive retinal detachment (Study Group) and nondiabetic eyes with rhegmatogenous retinal detachment (Control Group) after lens-sparing PPV.rp Results: Fifty-nine eyes of 55 subjects treated with gas (GT; 29 eyes in the Study and 30 in the control group; Mean follow-up: 381.41 [±309.17] days) and 42 eyes of 41 subjects treated with silicone oil tamponade (SOT; 10 eyes in the Study and 32 in the control group; mean follow-up: 326.50 [±239.59] days) were included. The prediction model for postoperative lens densitometry progression indicated that the increase in lens densitometry was lower in the study group than in the control group, regardless of the type of tamponade used. A second adjusted prediction model, including only age and baseline lens densitometry-matched eyes, further confirmed that the study group experienced a lower increase in lens densitometry in both SOT and GT cases than the control group.

Conclusions: The increase in lens nuclear sclerosis is more pronounced in nondiabetic eyes than in those with PDR after lens-sparing vitrectomy. These findings support the hypothesis that ischemia in PDR may protect against the development of nuclear cataracts following PPV.