Incidence and Risk Factors for Retinal Detachments and Tears after Cataract Surgery: An Analysis of the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight)

Abstract

Purpose : To determine the incidence and risk factors for rhegmatogenous retinal detachment (RRD) and retinal tears (RT) following cataract surgery.

Methods : Retrospective, cohort analysis of the IRIS Registry was performed. Eyes of patients aged 40 years or older undergoing cataract surgery from 2014-2017 were included. Eyes with history of RRD or RT were excluded. Incidence of RRD and RT, identified using relevant CPT codes, within one year after cataract surgery were the primary outcomes. Multivariable logistic regression was used to evaluate risk factors for RRD and RT after cataract surgery including demographic features (age, sex, race, ethnicity), ocular comorbidities (lattice degeneration, posterior vitreous detachment (PVD), high myopia), and intraoperative factors (hypermature cataract, pseudoexfoliation, floppy iris syndrome, complex surgery CPT code).

Results : Of 3,177,195 eligible eyes (1,983,712 patients), RRD and RT occurred in 6,690 (0.21%) and 5,489 (0.17%) within one year after cataract surgery. Logistic regression odds ratios (OR; 95% CI) showed increased risk of RRD (OR=3.12; 95% CI=2.96-3.28; P<0.001) and RT (OR=1.88; 95% CI=1.78-1.98; P<0.001) for males vs females. Risk was higher in younger patients compared to older patients (ages > 70 yrs), peaking at ages 40-50 yrs for RRD (OR=9.67; 95% CI=8.71-10.74; P<0.001) and ages 51-60 yrs for RT (OR=4.3; 95% CI=3.96-4.66; P<0.001). RRD and RT risk increased in eyes with lattice degeneration (OR=11.09; 95% CI=10.36-11.87; P<0.001 and OR=44.33; 95% CI=41.88-46.92; P<0.001), high myopia (OR=1.35; 95% CI=1.27-1.42; P<0.001 and OR=1.38; 95% CI=1.3-1.46; P<0.001), and eyes with PVD (OR=1.48; 95% CI=1.38-1.6; P<0.001 and OR=1.53; 95% CI=1.42-1.66; P<0.001). Complex surgery CPT code increased RRD risk (OR=1.33; 95% CI=1.23-1.45; P<0.001).

Conclusions : Analysis of the IRIS Registry revealed RRD and RT incidence are low (0.21% and 0.17%, respectively) within one year after cataract surgery. Lattice degeneration, younger age, male sex, PVD, and high myopia conveyed increased risk for RRD and RT. These low incidence rates and risk factors are consistent with prior studies supporting their validity. These data from a large, national database may aid in pre-operative counseling of prospective cataract surgery patients.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.