Posterior vitreous detachment and retinal detachment following cataract extraction

PURPOSE OF THE REVIEW: Cataract surgery induces considerable vitreous modifications that can lead to posterior vitreous detachment. Studies indicate that these changes, whether combined or not with peripheral retinal degenerations such as lattice areas, carry risk for subsequent retinal breaks or detachment. RECENT FINDINGS: The incidence of retinal detachment increases after cataract extraction, but it decreases with improved surgical technique. Postoperative posterior vitreous detachment is a major promoter of retinal detachment after cataract surgery and is related to onset of most retinal tears leading to retinal detachment. Vitreous body destabilization increases the incidence of retinal detachment after surgery; this destabilization of the vitreous body can result from aggressive surgical technique, intraoperative or postoperative posterior capsule breaks, high myopia and retinal detachment in the fellow eye. These factors can act alone or together to determine the onset of anomalous forms of posterior vitreous detachment; in such cases, retinal breaks frequently develop and culminate in retinal detachment. SUMMARY: Vitreous modifications occurring after cataract extraction in patients without preoperative posterior vitreous detachment may be involved in the onset of postoperative retinal detachment. Careful postoperative follow-up is recommended in these patients to allow early detection of posterior vitreous detachment arising after surgery.