Be aware of cataracts following Pars Plana Vitrectomy (PPV): what should be considered?

Background: Pars Plana Vitrectomy (PPV) is a vitreoretinal surgical technique that allows access to the posterior part of the eye, with an average of 225,000 vitrectomies performed annually in the United States. However, there is an incline with the number of cataract formation as a complication following PPV surgery. In a study in the UK involving 2000 eyes after the PPV procedure, the risk of cataracts was found to be 40%, and 52% of patients would undergo cataract surgery within the first year. The development of cataracts after PPV is associated with several risk factors; however, the risk factors for developing cataracts are still unclear. Therefore, a systematic review was conducted regarding the risk factors for developing cataracts after PPV. Methods: This systematic review followed the Preferred Reporting Items of Systematic Reviews (PRISMA) guidelines. Studies were identified through an electronic systematic search of PubMed, Embase (Elsevier), Cochrane Central (Wiley), Scopus (Elsevier), manual searching, and ClinicalTrials.gov. The search keywords used were related to “cataract”, “pars plana vitrectomy”, and “risk factor” using the Boolean operator AND and OR. We limited the studies from 2013 until 2023. All studies that discussed cataract risk factors after PPV surgery using English language will be included. Result: From 495 studies, based on inclusion and exclusion criteria, we included 6 studies with a total sample of 2.902 eyes. Risk factors associated with cataracts after PPV surgery were preoperative (older age, RRD with involvement of macular, lens status) and intraoperative (type of tamponade). It took 24 months after PPV surgery for the patient to undergo cataract surgery. Conclusion: Preoperative conditions and surgical intervention might affect the formation and progression of cataracts. Therefore, an ophthalmologist should consider several risk factors for cataract formation after PPV.