Purchase this article with an account.
Vincent Daien, Annick Lepape, Didier Heve, Isabelle Carrière, Max Villain; Risks factors of retinal detachment following cataract surgery in a national population study between 2009 and 2012. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):672.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Cataract surgery continues to improve, with reduced incision size and multifocal lens technologies. Increasingly, it is performed in younger persons and clear lens extraction for correction of refractive errors or presbyopia is gaining popularity. The aim of this study was to assess the incidence and risk factors of retinal detachment (RD) following cataract surgery. Secondary objective was to estimate the risk reduction of RD by year of delay of cataract surgery.
The data for all patients over 40 years who underwent cataract surgery in France between January 2009 and December 2012 were collected from the national administrative database PMSI (Programme de Médicalisation des Systèmes d'informatique). Incidence rates of RD after cataract surgery were calculated for each operated patient. Cox's proportional hazard regression model was used to analyze the risk factors associated to RD following cataract surgery. Hazard Ratio (HR) for risk reduction of RD per year of surgery delay was estimated.
In 4 years, 2 685 534 eyes in 1,791,587 persons (60.4% women, mean age ± SD 73.9 ±9.5 years) underwent a cataract surgery in France and 15,590 patients suffered from a RD. The cumulative probability of RD after cataract surgery increased in a nearly linear manner over the study period: 0.37%, 0.59%, 0.74%, 0.97%, at 1, 2, 3 and 4 years after cataract surgery. The mean delay for RD onset was 25 months. Multi-adjusted HR associated with an increased risk of RD was 5.25 (95% CI 5.11 to 5.40) in age group 40-45, 3.64 (95% CI 3.59 to 3.75) in age group 55-64 years and 1.98 (95% CI 1.94 to 2.02) in age group 65-74 as compared with 75 years and older patients. Male gender (HR=2.07; 95% CI=2.04 to 2.11), a history of diabetes (HR=1.27; 95% CI=1.24 to 1.30), high myopia (HR=6.70; 95% CI=6.44 to 6.97), eye traumatism (HR=5.10; 95% CI=4.77 to 5.44) and per-operative capsular rupture (HR=4.60; 95% CI=4.31 to 4.92) were also at higher risk of RD following cataract surgery.
Risk factors for RD after cataract surgery were younger age, male gender, extracasular extraction technic, per-operative capsular rupture and a history of diabetes or high myopia or eye traumatism. Each year delay of surgery in patient operated before 70 years of age could reduce the rate of RD after cataract surgery. Optimal timing for cataract surgery a pivotal issue for public health policies.
This PDF is available to Subscribers Only