Retinal detachment in pseudophakic eyes with and without Nd:YAG laser posterior capsulotomy.
OBJECTIVE
This study aimed to determine whether the characteristics of pseudophakic retinal detachment (RD) differ in eyes with and without a neodymium (Nd):YAG laser capsulotomy to identify features that might help to treat capsulotomy patients better.


METHODS
The study design was a retrospective cohort study of 129 consecutive eyes, 61 with a capsulotomy and 68 control eyes with an intact posterior capsule, in which a primary rhegmatogenous RD developed after a strictly uncomplicated extracapsular cataract extraction and intraocular lens implantation.


METHODS
The study was conducted in a primary referral center.


METHODS
Number, type, and location of retinal breaks and type and extent of RD were measured.


RESULTS
Risk factors predisposing to RD did not differ between the capsulotomy and control group. The median interval from cataract surgery to RD was expectedly longer in the capsulotomy group (4.1 years vs. 1.5 years, P < 0.001). The mean number of retinal breaks was larger in the capsulotomy group (1.7 vs. 1.1, P = 0.05), especially in upper quadrants (82 of 103 vs. 48 of 77, P = 0.024). Capsulotomy eyes also had a trend to have more atrophic holes that caused detachment relative to horseshoe breaks (34 of 103 vs. 15 of 77, P = 0.062). The type and extent of RD were similar in the two groups.


CONCLUSIONS
This pilot study suggests that atrophic holes, particularly in the superior quadrants, may lead to RD preferentially after posterior capsulotomy. Early identification and treatment of such breaks might decrease the number of pseudophakic detachments after capsulotomy.
Ranta
P
P
Department of Ophthalmology, Helsinki University Central Hospital, Finland.
Kivelä
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000473:pathology; D002387:Cataract Extraction; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects*; D007903:Lens Capsule, Crystalline / Q000473:pathology / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019591:Pseudophakia / Q000150:complications*; D012163:Retinal Detachment / Q000209:etiology*; D012167:Retinal Perforations / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors