Abstract
Purpose :
To identify whether tobacco use is associated with a greater risk of postoperative complications in retinal detachment repair surgery.
Methods :
This retrospective cohort study utilized the TriNetX database, a national electronic medical records research network with 60 healthcare organizations in the USA. CPT and ICD codes were used to classify post-surgical outcomes of patients undergoing noncomplex pars plana vitrectomy for retinal detachments from 11/2003 - 11/2023. Cohort 1 was composed of patients without nicotine dependence at the time of surgery (n = 12,817). Cohort 2 was composed of patients with nicotine dependence at the time of surgery (n = 2,584). These cohorts were compared based on the incidence of the following in either eye within one year of surgery: Vitreous hemorrhage (VH), primary open-angle glaucoma (POAG), blindness, purulent endophthalmitis, proliferative vitreoretinopathy (PVR), repeat retinal detachment surgery, and cataract surgery. Statistical analysis included chi-squared testing to compare complication rates.
Results :
Of the patients in this study, 16.8% were active tobacco users at the time of surgery. Patients with nicotine dependence were more likely to have PVR (4.0% vs 3.1%; p=0.01) and blindness (2.3% vs 1.1%; p<0.01) within one year of surgery compared to those without nicotine dependence. There was no statistically significant difference in rates of repeat retinal detachment repair (17.4% vs 16.3%; p=0.14), POAG (8.7% vs 7.8%; p=0.09), VH (6.2% vs. 5.4%; p=0.07), purulent endophthalmitis (0.08% vs. 0.06%; p=0.19), or cataract surgery (14.4% vs 15.7%; p=0.08) in either eye within 1 year of surgery between patients with and without nicotine dependence, respectively.
Conclusions :
Our results indicate that nicotine dependence may increase the risk of PVR and blindness within one year of retinal detachment repair. Although the difference in these complications were statistically significant, the low incidence suggests limited postoperative complications secondary to nicotine use. This information is important clinically, as most patients undergo retinal surgery urgently without time for tobacco cessation.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.