To discuss the clinical effect of Berger′s space vitrectomy assisted by optical coherence tomography (OCT) in posterior capsular lens.

A study was conducted on 73 patients (73 eyes) who underwent phacoemulsification cataract extraction combined with intraocular lens implantation and vitrectomy at the Ophthalmology Department of Tongji Hospital affiliated to Tongji University from January 2020 to April 2021. Among them, there were 37 males (37 eyes) and 36 females (36 eyes). The age ranges from 59 to 79 years, with an average of (65.1±4.2) years. According to the different treatment of Berger gap, they were divided into traditional group and Berger resection group. All affected eyes underwent silicone oil filling at the same time. Patients of Berger resection group underwent a thorough resection of the anterior vitreous cortex within a range of 8 mm centered behind the posterior capsule of the lens during the first stage of surgery, with alternating negative pressure suction and cutting during the resection. Patients of traditional group underwent traditional surgery without managing the Berger gap. The gender, age, glycosylated hemoglobin, fasting blood glucose, cataract nucleus grading, preoperative intravitreal injection frequency, intraocular pressure, best corrected visual acuity (BCVA), axial length, surgical time, degree of opacification in the posterior capsule area after silicone oil removal, and optical density values of the two groups of patients were recorded. Age, axial length, glycosylated hemoglobin, fasting blood glucose, preoperative intravitreal injection frequency, intraocular pressure, surgical time, and posterior capsule optical density values conforming to a normal distribution, were expressed by ±s and compared by two ways repeated measurement ANOVA for inter group at each time point, and independent sample t test between groups. Gender, proportion of hypertension, cataract nuclear grading were described in terms of number and percentage of cases, and chi square test was used for inter group comparison. The degree of posterior capsule opacification was expressed in quartiles and median, and rank sum test was used for inter group comparison.

The minimum resolution angle logarithmic visual acuity (logMAR) BCVA of the affected eyes in the Berger resection group were (0.93±0.73), (0.62±0.18), (0.50±0.08), and (0.48±0.08) before surgery, after primary surgery for 1 month, before secondary oil removal, and after secondary oil removal for 3 months, respectively. Those of the traditional group were (0.90±0.10), (0.69±0.14), (0.56±0.12), and (0.52±0.61), respectively. After two ways repeated ANOVA, the differences between the two groups were statistically significant (F=19.35, P<0.05), and the interaction was not statistically significant (F=0.113, P>0.05). The differences between the groups were statistically significant (t=-2.36, P<0.05) after the second phase of oil extraction for 3 months. The iOCT optical density value of the Berger resection group was (0.60±0.03), while that of the traditional group was (0.86±0.04). The former was lower than the latter with a statistically significant difference between groups (t=20.04, P<0.05). The pentacam optical density values of the Berger resection group and the traditional group after oil extraction for 3 months were (4.21±0.51) and (5.37±1.28), respectively. There was a statistically significant difference between groups (t=-3.29, P<0.05). The primary stage surgical time in the Berger resection group and the traditional group were (60.33±10.08) min and (57.22±9.89) min, respectively. There was no statistically significant difference between the groups (t=0.89, P>0.05). After secondary oil removal for 3 months, the quartiles (median) of posterior capsule opacity in the Berger resection group and the traditional group were 1.00 (1.00) and 2.00 (2.00), respectively. The Berger resection group was lighter than the traditional group, and the difference was statistically significant (Z=3.27, P<0.05).

Complete resection of the vitreous cortex behind the posterior capsule of the lens can brighten posterior capsular opacity in the axial region after silicone oil removal surgery.