Long-term visual outcomes of vitrectomy for cystoid macular edema due to nonischemic central retinal vein occlusion.

PURPOSE: To report the long-term surgical outcome of vitrectomy for cystoid macular edema due to nonischemic central retinal vein occlusion (CRVO). METHODS: A retrospective chart review of 25 consecutive eyes (25 patients) with cystoid macular edema due to nonischemic CRVO treated with vitrectomy was performed. All patients underwent a pars plana vitrectomy with the creation of a posterior vitreous detachment if still attached. Simultaneous phacoemulsification with intraocular lens implantation was also performed in phakic eyes. The main outcome measures were best-corrected visual acuity (BCVA) and changes in macular edema shown by contact-lens biomicroscopy. The mean follow-up time was 49 months (range, 16-108). RESULTS: The median BCVA before surgery was 0.31 and the median BCVA at last follow-up was 0.67. The BCVA at the last follow-up improved at least two Snellen lines in 17 (68%), remained unchanged in 4 (16%), and worsened in 4 (16%). The BCVA was 20/40 or better in 3 eyes (12%) preoperatively and in 18 eyes (72%) at the last follow-up. During the follow-up, four patients progressed to ischemic CRVO; one of them had neovascular glaucoma requiring surgical intervention. CONCLUSION: The data indicate that vitrectomy appears to be a possibly effective treatment in some eyes with cystoid macular edema associated with nonischemic CRVO.

[Clinical features of idiopathic macular holes-differences between sexes and stages].

PURPOSE: The purpose of this study was to evaluate the differences in the clinical features of idiopathic macular holes between sexes and stages. METHODS: Five hundred and twenty-six eyes of 480 patients with stage 3 or 4 idiopathic macular hole that had undergone vitrectomy were observed consecutively in this study. The each stage ratio, bilaterality, and affected eye were examined and the differences in age, hole duration, hole size, visual acuity, refractive power, axial length, and corneal refractive power were evaluated. RESULTS: Twenty-six % of the cases were stage 4 in males and 31% in females. There were no significant differences in bilaterality or affected eye between the sexes. Younger age and larger size were found in females of stage 3. Larger size was found in stage 4. More myopic eye and longer axial length were found in males of stage 4. There were no significant differences in hole duration and visual acuity between sexes or stages. CONCLUSIONS: In females the onset of macular hole occurred at a younger age than in males, size of the hole was larger from an earlier stage, and refractive power was less myopic. More myopic eye and longer axial length were found in stage 4, especially in males. This fact might be related to the existence of posterior vitreous detachment. We concluded that there were some differences in the mechanism of the onset and the progression of idiopathic macular hole between males and females.

Variables That Influence Visual Acuity After Macular Hole Surgery.

Purpose: To evaluate the variables that influence visual acuity and visual improvement after macular hole surgery.Methods: Our study included 421 eyes in which macular holes were successfully closed after surgery and followed up at least 1 year after the last surgery. Surgical techniques were conventional methods (Group 1: 350 eyes) with retinal pigment scalping of the macular hole basis added in the refractory cases (Group 2: 71 eyes). The variables used for the multiple regression were gender, age, preoperative visual acuity, hole stage, duration of symptoms, hole size, and axial length.Results: The variables that most influenced postoperative visual acuity were as follows: Group 1: gender (r = -0.011, P =.016), age (r = -0.17, P =.005), preoperative visual acuity (r = 0.51, P <.0001), duration of symptoms (r = -0.015, P <.0001), and axial length (r = -0.090, P =.045). Group 2: age (r = -0.18, P =.047), and preoperative visual acuity (r = 0.47, P <.0001).Conclusions: The variables that influenced visual acuity and visual improvement after macular hole surgery were common. In Group 1: gender, age, preoperative visual acuity, duration of symptoms, and axial length; in Group 2: age and preoperative visual acuity.

Incidence of Reopening and Variables That Influence Reopening After Macular Hole Surgery.

Purpose: To evaluate the incidence and variables of reopening of macular holes after macular hole surgery.Methods: Our study included 467 eyes in which macular holes were successfully closed after surgery. Surgical techniques consisted of conventional methods (358 eyes) and scalping methods (109 eyes) with retinal pigment scalping of the macular hole basis added in such cases: reoperation, hole size (more than 0.4 disc diameter), duration of symptoms (more than 2 years). Long term incidence of reopening was predicted by life table method. After we compared reopened cases with non-reopened cases, the variables of gender, stage, biocular occurrence, age, duration of symptoms, hole size, preoperative visual acuity, refraction axial length ratio, and intraoperative retinal tears were used for the multiple regression.Results: Reopening was found in 20 eyes (5.6%) treated by conventional methods and in 10 eyes (9.2%) treated by scalping methods. Survival ratio was 87% for the conventional methods in 6 years and 79% for the scalping methods in 5 years. The variables influencing reopening were as follows: conventional methods: gender (r = 0.065, P =.19), biocular occurrence (r = 0.12, P =.026), and refraction axial length ratio (r = -0.11, P =.045); scalping methods: hole size (r = 0.14, P =.25).Conclusions: Incidence of reopening in scalping methods was high. The variables that influenced reopening after macular hole surgery were biocular occurrence and refraction axial length ratio in conventional methods. The shape of the eye may be related to reopening.

Refraction and Anterior Chamber Depth Change After Vitrectomy for Pseudophakia.

Purpose: To evaluate the association between the vitreous and the refractive error in pseudophakia.Methods: Vitrectomy was performed in 67 eyes of 61 patients who underwent cataract surgery. Vitrectomy was needed for epiretinal membrane in 30 eyes, macular edema in 22 eyes, macular hole in 3 eyes, lamelar macular hole in 2 eyes, macular hole in 3 eyes, lamelar macular hole in 2 eyes, vitreous opacity in 6 eyes, and vitreous hemorrhage in 4 eyes. Refraction was measured before the operation, and 1 month, 3 months, 6 months, and 12 months after operation. Anterior chamber depth was measured in 10 eyes before the operation, and 1 month, 3 months, and 6 months after operation. We evaluated the refractive error after vitrectomy in 49 eyes that had predicted refraction.Results: The mean value of refractive change was -0.3 D 1 month postoperatively, and then gradually became positive. The variation of refraction (6-month postoperative refraction minus preoperative refraction) was negatively correlated with preoperative refraction (P =.0052, R(2) = 0.146). If preoperative refraction was more myopic than -1.5 D, then refraction became positive. If preoperative refraction was not more myopic than -1.5 D, then refraction became negative.Conclusion: About 15% of postoperative refractive error may be associated with the vitreous, but further investigation is required.

[Factors related to intraoperative retinal breaks in macular hole surgery].

PURPOSE: To evaluate the factors of intraoperative retinal breaks in macular hole surgery. METHODS: This study included 558 eyes of 506 patients who underwent idiopathic macular hole surgery by one surgeon. Multiple regression was performed using the variables of gender, age, affected eye, lens status, stage, duration of symptoms, hole size, axial length, and lattice degeneration. RESULTS: The rate of retinal breaks was higher in stage 3 (16.0%) than in stage 4 (8.2%) (p = 0.014). In eyes with lattice degeneration intraoperative retinal breaks occurred in about 40% of the cases. Major factors were as follows: lattice degeneration (r = 0.24, p < 0.0001) in all eyes, stage (r = 0.090, p = 0.048) in eyes without lattice degeneration, and gender (r = -0.18, p = 0.035) in eyes of stage 4 without lattice degeneration. CONCLUSIONS: The factors of intraoperative retinal breaks in macular hole surgery were lattice degeneration in all eyes and stage 3 in eyes without lattice degeneration. The high incidence of intraoperative retinal breaks in stage 3 was mainly due to the occurrence of posterior vitreous detachment. Male gender was a significant factor associated with intraoperative retinal breaks.

[Operculum in idiopathic macular holes].

PURPOSE: To detect the factors related to the operculum in idiopathic macular holes and present a pathogenesis of idiopathic macular holes. METHODS: This study included 583 eyes of idiopathic macular hole that underwent macular hole surgery. To detect the factor related to the operculum, the variables of age, duration of symptoms, hole size, preoperative visual acuity, refraction, axial length, refraction axial length ratio were used for the comparison between two groups and multiple regression. The success rate of surgery and postoperative visual acuity were examined whether the operculum was present or not. RESULTS: The variables that were significantly related to the operculum were as follows: refraction axial length ratio (r = 0.18, p = 0.0092) in women of stage 3, duration of symptoms (r = -0.44, p < 0.001), preoperative visual acuity (r = -0.33, p = 0.0025), and refraction axial length ratio (r = -0.22, p = 0.020) in women of stage 4, and age (r = 0.19, p = 0.047) in men of stage 3. There were no significant differences in the success rate of surgery and postoperative visual acuity whether the operculum was present or not. CONCLUSIONS: Generally, operculum tends to occur in aged and round eyes and possibly does not occur in younger and back projected eyes because of retinal fissure. In women of stage 4, the operculum is possibly a torn retina and does not occur in atrophic holes.

Advantage of combined procedure in vitreous surgery.

Lens preservation facilitates the progression of nuclear cataracts after vitreous surgery among patients over 45 years old, and postoperative nuclear cataracts frequently necessitate intraocular lens surgery. Once the lens is removed, the fundus from the posterior pole to the ciliary process becomes recognizable and surgically reachable, thus making total vitreous removal possible. The complete removal of the incarcerated vitreous to the scleral wound prevents postoperative vitreous base tears, and anterior hyaloidal fibrovascular proliferation. Simultaneous vitreous surgery plus intraocular lens surgery (triple surgery) will prevent these complications before they arise. Triple surgery for patients over 45 years of age is reasonable even if they have amplitude of accommodation, and is an effective surgical strategy in that it improves both the result of the vitreous surgery and the patient's quality of life.

Results of macular hole surgery combined with PEA and IOL.

We evaluated the factors affecting closure and postoperative visual acuity, as well as complications among idiopathic macular hole surgery cases comprising 631 eyes in 576 patients. Almost all the surgeries were combined with simultaneous intraocular lens surgery (triple surgery). In some cases, the standard method was accompanied by internal limiting membrane peeling around the macular hole or abrasion of retinal pigment epithelium at the base of the macular holes. We found that male gender and short eye axial length were associated with closure and postoperative visual acuity. Although the frequency of peripheral retinal tears during surgery was high, the frequency of postoperative retinal detachment was less than 2%. The reopening frequency was about 5% among all cases, and was highest among eyes that underwent the abrasion method. There were no other significant complications. Internal limiting membrane peeling is effective for treatment of cases with unfavorable preoperative conditions. However, the standard method is sufficiently effective for cases with favorable preoperative conditions. Further analysis is required to evaluate postoperative visual function by methods other than visual acuity. Further study of internal limiting membrane peeling, as a treatment alternative, is also required.

Results of epiretinal membrane removal combined with PEA and IOL.

We examined 558 eyes from 538 surgical cases of idiopathic epiretinal membrane with respect to the effectiveness of the triple surgery that involves concomitant intraocular lens surgery, the most appropriate timing for the evaluation of postoperative visual acuity, and the relationship between the pre- and postoperative visual acuity. From the viewpoint of the timing of the intraocular lens surgery, we classified our patients into 4 groups: (1) a phakic eye group; (2) a two-step surgery group; (3) a triple surgery group; and (4) an intraocular lens group. The visual acuity evaluation was performed in 22 eyes from the phakic eye group based on the patient's age being 45 years or younger, in all 326 eyes from the triple surgery group, and in all 86 eyes from the two-step surgery group. We excluded the intraocular lens group from the visual acuity evaluation. The timing of the visual acuity evaluation was one year after the surgery for the phakic eye and triple surgery groups, and one year after the intraocular lens surgery for the two-step surgery group. The postoperative visual acuity was correlated with the patient's age. When a patient was less than 55 years of age, the postoperative visual acuity correlated positively with age. In contrast, when a patient was 55 years of age or older, it correlated inversely with age. The postoperative visual acuity was significantly correlated with the preoperative visual acuity, and it was possible to predict the postoperative visual acuity based on a regression equation. The preoperative visual acuity necessary for a postoperative visual acuity of 20/20 or more was 20/20 for patients under 40 years old, 20/40 for 40-59 years, 20/32 for 60-79 years, and 20/20 for 80 years and older.

DNA sequence and comparison of virulence plasmids from Rhodococcus equi ATCC 33701 and 103.

The virulence plasmids of the equine virulent strains Rhodococcus equi ATCC 33701 and 103 were sequenced, and their genetic structure was analyzed. p33701 was 80,610 bp in length, and p103 was 1 bp shorter; their sequences were virtually identical. The plasmids contained 64 open reading frames (ORFs), 22 of which were homologous with genes of known function and 3 of which were homologous with putative genes of unknown function in other species. Putative functions were assigned to five ORFs based on protein family characteristics. The most striking feature of the virulence plasmids was the presence of a 27,536-bp pathogenicity island containing seven virulence-associated protein (vap) genes, including vapA. These vap genes have extensive homology to vapA, which encodes a thermoregulated and surface-expressed protein. The pathogenicity island contained a LysR family transcriptional regulator and a two-component response regulator upstream of six of the vap genes. The vap genes were present as a cluster of three (vapA, vapC, and vapD), as a pair (vapE and vapF), or individually (vapG; vapH). A region of extensive direct repeats of unknown function, possibly associated with thermoregulation, was present immediately upstream of the clustered and the paired genes but not the individual vap genes. There was extensive homology among the C-terminal halves of all vap genes but not generally among the N-terminal halves. The remainder of the plasmid consisted of a large region which appears to be associated with conjugation functions and a large region which appears to be associated with replication and partitioning functions.

[Refraction and anterior chamber depth change after vitrectomy for pseudophakia].

PURPOSE: To evaluate the association between the vitreous and the refractive error in pseudophakia. METHODS: Vitrectomy was performed in 67 eyes of 61 patients who underwent cataract surgery. Vitrectomy was needed for epiretinal membrane in 30 eyes, macular edema in 22 eyes, macular hole in 3 eyes, lamelar macular hole in 2 eyes, vitreous opacity in 6 eyes, and vitreous hemorrhage in 4 eyes. Refraction was measured before the operation, and 1 month, 3 months, 6 months, and 12 months after operation. Anterior chamber depth was measured in 10 eyes before the operation, and 1 month, 3 months, and 6 months after operation. We evaluated the refractive error after vitrectomy in 49 eyes that had predicted refraction. RESULTS: The mean value of refractive change was -0.3 D 1 month postoperatively, and then gradually became positive. The variation of refraction (6-month postoperative refraction minus preoperative refraction) was negatively correlated with preoperative refraction (p = 0.0052, R2 = 0.146). If preoperative refraction was more myopic than -1.5 D, then refraction became positive. If preoperative refraction was not more myopic than -1.5 D, then refraction became negative. CONCLUSION: About 15% of postoperative refractive error may be associated with the vitreous, but further investigation is required.

Pars plana filtration with multiple laser perforation of the uvea for neovascular glaucoma following proliferative diabetic retinopathy.

PURPOSE: To evaluate the effect of pars plana filtration with multiple laser perforation of the uvea in neovascular glaucoma patients following proliferative diabetic retinopathy. METHODS: In 18 eyes of 13 patients, after a fornix-based conjunctival incision, two 9 x 3 mm, thin, rectangular scleral flaps were created 3-6 mm posterior to the limbus. The remaining layers of sclera under each flap were removed. The exposed uvea was irradiated at a mean of 60.6 spots with an argon laser just to the point of perforation. After the posterior chamber fluid escaped, the flaps were sutured. RESULTS: The mean preoperative intraocular pressure (IOP) was 36.4 +/- 9.0 mm Hg. After an average follow-up of 16.6 +/- 5.9 months, the mean final postoperative IOP was 16.6 +/- 4.4 mm Hg. The postoperative IOP was below 21 mm Hg in 3 (16.7%) of the 18 eyes without medication, in 14 (77.8%) on anti-glaucoma eye drops, and in 16 (88. 9%) on anti-glaucoma eye drops and an oral carbonic anhydrase inhibitor. Snellen visual acuity improved by more than 2 lines in 7 of the 18 eyes, worsened by this amount in 3, and remained within baseline +/- 2 lines in 8. CONCLUSION: This procedure is an effective treatment for neovascular glaucoma patients following proliferative diabetic retinopathy.

Multicenter retrospective study of retinal detachment associated with atopic dermatitis.

PURPOSE: Epidemiological and clinical study of retinal detachment associated with atopic dermatitis. METHODS: A multicenter retrospective study. RESULTS: We analyzed the records of 417 eyes of 348 patients operated on during 5 years from 1989 to 1993 and followed up for more than 6 months by vitreo-retinal specialists in 33 hospitals throughout Japan. The number of eyes operated on increased yearly from 42 in 1989 to 132 in 1993. These cases associated with atopic dermatitis were 2.3% of the average number of eyes operated on for rhegmatogenous retinal detachment during the same period, but when restricted to the Kanto area or further to Tokyo only, the percentage was as high as 3.8% and 4.7%, respectively. CONCLUSION: Clinical characteristics of retinal detachment previously reported, such as traumatic slapping or rubbing of the lids by patients as the most likely pathogenetic factor, and high incidence of cataract and proliferative vitreoretinopathy, were confirmed. The primary surgical procedure was scleral buckling in 78% of the cases and vitreous surgery in 22%, and initial and final reattachment rates were 75.3% and 92.6%, respectively.

[Variables that influence visual acuity after macular hole surgery].

PURPOSE: To evaluate the variables that influence visual acuity and visual improvement after macular hole surgery. METHODS: Our study included 421 eyes in which maculor holes were successfully closed after surgery and followed up at least 1 year after the last surgery. Surgical techniques were conventional methods (Group 1: 350 eyes) with retinal pigment scalping of the macular hole basis added in the refractory cases (Group 2: 71 eyes). The variables used for the multiple regression were gender, age, preoperative visual acuity, hole stage, duration of symptoms, hole size, and axial length. RESULTS: The variables that most influenced postoperative visual acuity were as follows: Group 1: gender (r = -0.011, p = 0.016), age (r = -0.17, p = 0.005), preoperative visual acuity (r = 0.51, p < 0.0001), duration of symptoms (r = -0.015, p < 0.0001), and axial length (r = -0.090, p = 0.045). Group 2: age (r = -0.18, p = 0.047), and preoperative visual acuity (r = 0.47, p < 0.0001). CONCLUSIONS: The variables that influenced visual acuity and visual improvement after macular hole surgery were common. In Group 1: gender, age, preoperative visual acuity, duration of symptoms, and axial length; in Group 2: age and preoperative visual acuity.

[Incidence of reopening and variables that influence reopening after macular hole surgery].

PURPOSE: To evaluate the incidence and variables of reopening of macular holes after macular hole surgery. METHODS: Our study included 467 eyes in which maculor holes were successfully closed after surgery. Surgical techniques consisted of conventional methods (358 eyes) and scalping methods (109 eyes) with retinal pigment scalping of the macular hole basis added in such cases: reoperation, hole size (more than 0.4 disc diameter), duration of symptoms (more than 2 years). Long term incidence of reopening was predicted by life table method. After we compared reopened cases with non-reopened cases, the variables of gender, stage, biocular occurrence, age, duration of symptoms, hole size, preoperative visual acuity, refraction axial length ratio, and intraoperative retinal tears were used for the multiple regression. RESULTS: Reopening was found in 20 eyes (5.6%) treated by conventional methods and in 10 eyes (9.2%) treated by scalping methods. Survival ratio was 87% for the conventional methods in 6 years and 79% for the scalping methods in 5 years. The variables influencing reopening were as follows: conventional methods: gender (r = 0.065, p = 0.19), biocular occurrence (r = 0.12, p = 0.026), and refraction axial length ratio (r = -0.11, p = 0.045); scalping methods: hole size (r = 0.14, p = 0.25). CONCLUSIONS: Incidence of reopening in scalping methods was high. The variables that influenced reopening after macular hole surgery were biocular occurrence and refraction axial length ratio in conventional methods. The shape of the eye may be related to reopening.

[Factors related to initial success in macular hole surgery].

PURPOSE: To evaluate the factors of initial success in macular hole surgery. METHODS: This study included 526 eyes of 480 patients who underwent idiopathic macular hole surgery by one and the same surgeon. Surgical methods included conventional method (392 eyes), retinal pigment epithelium (RPE) scalping (61 eyes), internal limiting membrane (ILM) removal (62 eyes), and RPE scalping combined with ILM removal (11 eyes). To evaluate the factors of initial success multiple regression was performed using the variables of (gender, age, stage, duration of symptoms, hole size, axial length, and preoperative visual acuity). RESULTS: The rate of initial success was 81.4% in all eyes, 80.9% in the conventional method, 78.7% in RPE scalping, 83.9% in ILM removal, and 100% in RPE scalping combined with ILM removal. Significant factors of initial success were as follows: gender (r = -0.091, p = 0.053), age (r = -0.14, p = 0.0062), duration of symptoms (r = -0.23, p < 0.0001), hole size (r = -0.23, p < 0.0001), and axial length (r = -0.21, p < 0.0001) in the conventional method, hole size (r = -0.56, p = 0.0006) in ILM removal and stage (r = -0.43, p = 0.0011) and preoperative visual acuity (r = 0.30, p = 0.018) in RPE scalping. CONCLUSIONS: Significant factors of initial success were being male being young, shorter duration of symptoms, smaller hole size, and shorter axial length in the conventional method, smaller hole size in ILM removal and stage 4 and better preoperative visual acuity in RPE scalping method.

[Clinical features of idiopathic macular holes].

PURPOSE: The purpose of this study was to evaluate the clinical features of idiopathic macular holes. MATERIALS AND METHODS: The clinical features were examined in consequentive 526 eyes of 480 patients with idiopathic macular hole who underwent vitrectomy. RESULTS: Sixty-seven% of the patients were female. The mean onset age was 64.4 years of age and 60% of the cases were in their 60's at the time of onset. The mean refractive value was -0.66 dioptor and 40% of the cases were emmetropia with a refractive value between -1.0 dioptor and +1.0 dioptor. The onset age was positively correlated with refractive value. The visual acuity was negatively correlated with onset age, duration after onset, and the size of the macular hole. The duration was positively correlated with onset age. The size of the macular hole was positively correlated with age and duration. The factors for good visual acuity were determined by bilaterality, youth, or small size. Also we found the factors for large size of macular holes to be female gender, long duration of the hole, being in stage 4, and low visual acuity. CONCLUSIONS: The incidence of idiopathic macular hole is seen more in eyes of patients in their 60's and in emmetropic eyes. Patients with myopic eyes tend to have younger onset. The size of the macular hole in females tends to be larger than in males.

Vitreous surgery for traumatic macular holes.

PURPOSE: To review the anatomic and visual outcomes of a series of patients with traumatic macular holes who underwent vitreous surgery without adjunctive therapy. METHODS: We performed a retrospective chart review of 23 patients who underwent vitrectomy, fluid-gas exchange, and sulfur hexafluoride gas tamponade for traumatic macular holes. Anatomic success rate and final visual improvement after the surgery were studied. RESULTS: Medical records of 23 patients (23 eyes) who underwent this procedure were reviewed. Closure of the macular hole was achieved in 16 (70%) eyes with one surgery and in 22 (96%) of the 23 eyes with two surgeries. The mean best-corrected preoperative visual acuity was 20/160, and postoperative visual acuity was 20/60 with a mean (+/- standard deviation) follow-up of 23+/-13 months (range 3-56 months). Fourteen (61 %) of the 23 eyes achieved a best-corrected postoperative visual acuity of 20/60 or better, and 11 (48%) of the 23 eyes achieved 20/40 or better. Twenty (87%) of the 23 eyes achieved at least two lines of visual improvement. CONCLUSIONS: Vitreous surgery without adjunctive therapy for traumatic macular holes can lead to anatomic success and visual acuity improvement in most eyes.

Vitreous opacification after neodymium:YAG posterior capsulotomy.

PURPOSE: To describe the clinical picture in eyes that developed vitreous opacification behind the intraocular lens (IOL) after neodymium:YAG (Nd:YAG) laser posterior capsulotomy and determine whether this type of opacification tends to occur in patients with diabetes. SETTING: Shinjo Eye Clinic, Miyazaki, Japan. METHODS: The clinical course in 728 eyes that had Nd:YAG posterior capsulotomy was reviewed. RESULTS: After Nd:YAG posterior capsulotomy, opacification developed in the vitreous in contact with the IOL in 9 eyes (1.2%). All occurred in diabetic patients, and the vitreous opacification developed within 1 month after the capsulotomy. A vitrectomy was performed in 8 eyes and in 1, the opacification spontaneously absorbed. Vitreous opacification occurred in 8.9% of 101 eyes of diabetic patients, and the prevalence in diabetic eyes was significantly higher than in nondiabetic eyes (P < .0001). Nine of the diabetic eyes were opaque and 92 nonopaque. In the opaque eyes, the prevalence of panretinal photocoagulation was higher than in the nonopaque eyes (P = .013), and hemoglobin Alc (P = .030) was higher; the interval between cataract surgery and Nd:YAG capsulotomy was shorter (P = .047) and the final visual acuity, lower (P = .045). CONCLUSION: The prevalence of vitreous opacification after Nd:YAG laser posterior capsulotomy was significantly higher in diabetic than in nondiabetic eyes. Viterectomy was effective for this type of opacification.