Peak Occurrence of Retinal Detachment following Cataract Surgery: A Systematic Review and Pooled Analysis with Internal Validation

Abstract

Introduction Timing of retinal detachment (RD) following cataract surgery is of importance for both diagnostic and prognostic factors. However, results on RD onset-time following cataract surgery have been conflicting. Method A systematic pooled analysis of the literature regarding timing of retinal detachment following cataract surgery. Outcomes were verified against an independent dataset. Results Twenty-one studies, reporting on rates of RD in 3,352,094 eyes of 2,458,561 patients, met our inclusion criteria and were included in the analysis. The mean pooled time to RD following surgery was 23.12 months (95% CI: 17.79–28.45 months) with high heterogeneity between studies (I 2=100%, P < 0.00001). Meta-analytic pooling for the risk of retinal detachment revealed a risk of 1.167% (95% CI: 0.900 to 1.468, I 2=99.50%, P < 0.0001). A retrospective chart review identified 54 pseudophakic RD cases (mean age 65.5, 59.3% males). The 95% confidence interval for the mean time to RD was 3.1–6.75 years. Conclusions The interval between cataract surgery and RD in a pooled analysis revealed a mean time of approximately 1.5–2.3 years. However, there was high variability between studies. Validation based on our local results showed similar yet slightly longer time frames. Timing of pseudophakic retinal detachment might direct appropriate follow-up, assisting in earlier detection.

Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration Preferred Practice Pattern®

“…46 The overall risk of RRD after cataract surgery is approximately 1%. [47][48][49][50] The following conditions have been reported to increase the risk of RRD after cataract surgery: axial myopia, pre-existing vitreoretinal disease, male gender, younger age, vitreous prolapse into the anterior chamber, vitreous loss (ruptured posterior capsule/zonules), and spontaneous extension of the capsulotomy at the time of surgery. 51,52 One study suggests that in the absence of a posterior capsular tear at the time of cataract surgery, subsequent Nd:YAG laser capsulotomy may not increase the risk of retinal detachment.…”

Patient Safety in Ophthalmology

“…It was hypothesized to be caused by postsurgical anatomical and biochemical alterations in the vitreous [30]. Specifically, the smaller volume of IOL, compared to the volume of the cataractous lens, increases the total vitreous volume and consequently mobility of the vitreous [31].…”

Psödofakik Retina Dekolmanlı Hastaların Demografik ve Klinik Özellikleri ve Bunların Cerrahi Başarıya Etkisi

“…Retina kliniklerine başvuran PRD hastaların çoğunda makula tutulumu olduğu belirtilmektedir (40,41). Bartz-Schmidt ve ark.…”