Cataract Progression and Risk Factors for Cataract Surgery after Pars Plana Vitrectomy in Phakic Eyes: An IRIS® Registry (Intelligent Research in Sight) Analysis.

PURPOSE: To investigate the probability of cataract surgery after pars plana vitrectomy (PPV) in phakic eyes using the IRIS® Registry (Intelligent Research in Sight) and to identify risk factors for subsequent cataract surgery. DESIGN: Retrospective cohort analysis from the IRIS Registry. SUBJECTS: A total of 181 540 eyes of 169 184 patients underwent PPV from July 1, 2013 to September 30, 2022. METHODS: Adult patients aged 18 or older were included. To ensure that eyes were phakic at the time of vitrectomy, eyes with a prior diagnosis of pseudophakia or aphakia or those that underwent prior or concurrent cataract surgery or lensectomy were excluded. Eyes that underwent more than 1 vitrectomy were also excluded, and a minimum follow-up period of 3 months and look-back period of 6 months were required. Multivariable regression analyses were performed to assess risk factors for cataract surgery. MAIN OUTCOME MEASURES: Probability of cataract surgery within 2 years after PPV. RESULTS: The overall probability of cataract surgery within 2 years after PPV was 46%. On multivariable modified Poisson regression, major risk factors for cataract surgery included older age compared with age <40 years (relative risk [RR] = 1.42; 95% confidence interval [CI], 1.32-1.54, P < 0.001 for ages 40-49; RR = 2.31; 95% CI, 2.16-2.48 for ages 50-59; RR = 2.59; 95% CI, 2.42-2.78 for ages 60-69; RR = 2.28; 95% CI, 2.13-2.45 for ages 70-79; RR = 1.41; 95% CI, 1.30-1.52 for age ≥ 80 years), as well as baseline cataract (RR = 1.81; 95% CI, 1.78-1.84), whereas diabetes had a protective association (RR = 0.83; 95% CI, 0.82-0.85). Compared with standard vitrectomy, vitrectomy for retinal detachment (RR = 1.38; 95% CI, 1.35-1.42), macular hole (RR = 1.27; 95% CI, 1.24-1.31), and epiretinal membrane (RR = 1.18; 95% CI, 1.14-1.21) was significantly associated with an increased risk of cataract surgery, whereas vitrectomy with panretinal photocoagulation (RR = 0.90; 95% CI, 0.87-0.93) was significantly associated with a decreased risk of cataract surgery. CONCLUSION: In this national database, approximately half of phakic patients undergoing vitrectomy underwent cataract surgery within 2 years, with risk factors including age, baseline cataract, and vitrectomy for conditions related to abnormal vitreoretinal interface. Diabetes and vitrectomy with panretinal photocoagulation were protective factors. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.