Risk for Retinal Detachment After Phacoemulsification

Abstract

Risk for RD after phacoemulsification has almost halved for each 5-year period since its adoption in the mid 1980s. Younger patient age and male sex at surgery significantly increased risk for RD. Phacoemulsification requiring anterior vitrectomy vastly increased risk for RD.

Risk factors for retinal detachment following cataract surgery: the impact of posterior capsular rupture

“…Male gender is a well established risk factor considered to increase the RD rate by 2.5-fold 2 3. In our study, the respective HR was 2.0 (95% CI 1.03 to 3.88) and was significant in the univariate model (p=0.04) but not in the multivariate model (p=0.43).…”

“…The rate of RD in our study may also reflect a truly reduced incidence of RD in the phacoemulsification compared with extracapsular cataract extraction (ECCE) era. Clark et al 2 in a study of 65 055 eyes operated between 1989 and 2001 reported a 10-year RD rate of 0.68%, but when comparing consecutive time periods he found a significant drop in RD rates from 0.96% between 1989 and 1993 to 0.25% for those operated between 1999 and 2001. Lin et al 5 reported a 7-year cumulative RD rate of 0.84% in 9184 eyes having cataract surgery from 2000 to 2010, but this study included ECCE and the female:male ratio was 1:2.…”

“…However, because the number of eyes with PCR without vitreous loss was small (n=72), a larger sample size is needed to confirm whether such eyes have a different risk of subsequent RD. Another strength of this study, in common with the study of Lin et al ,5 is that our analysis was limited to first operated eyes to avoid bias due to correlation between eyes of the same patient 2 3…”

“…Clark et al 2 estimated a doubling of RD risk for every decade of younger age down to 50 years of age. However, the use of an extreme age group (>80 years) and not the mean age group of patients as the reference group, results in dramatically high OR figures that could easily be misinterpreted.…”

“…Age and axial length were both stratified into three comparably sized groups: <60 years, 60–80 years, >80 years and <23 mm, 23–25 mm and >25 mm, respectively. The age groups were chosen based on the fact that the appearance of posterior vitreous detachment (PVD) rises dramatically after the age of 60 years and in order to facilitate comparison with related previous studies 2 7 15. The calculation of the follow-up time was based on the assumption that all patients without an RD event and all patients where death was not recorded in the EMR were still under potential follow-up.…”