We know that pars plana vitrectomy, especially when a tamponade agent is used, will promote the progression of a cataract. However, this typically happens over the course of many months to over a year. When a cataract forms rapidly after vitrectomy, you have to be concerned for the possibility of posterior capsular violation at the time of vitrectomy. That’s the scenario facing guest surgeon Dr. Jonathan Lin a 2nd year vitreoretinal fellow and his attending, Dr. Ehsan Rahimy. The patient is a 57 year old status post buckle and vitrectomy for a macula-involving retinal detachment who developed a rapidly progressive cataract shortly after vitrectomy. The patient was referred to Dr. Lin for cataract surgery and possible vitrectomy/lensectomy given the high suspicion for posterior capsule violation. Let’s see how Dr. Lin manages this case and at the end we will talk about some pre-operative and intra-operative considerations when performing post-vitrectomy cataract surgery. Thank you Drs. Lin and Rahimy for sharing this case!
