Update on a long-term, prospective study of capsulotomy and retinal detachment rates after cataract surgery.
OBJECTIVE
To evaluate the retinal detachment risks and neodymium:YAG (Nd:YAG) capsulotomy rates associated with different cataract approaches and intraocular lens (IOL) styles in a long-term,prospective clinical study.


METHODS
Clinical practice of 1 ophthalmologist, Fort Collins, Colorado, USA.


METHODS
Prospectively studied were surgical approach, date, and complications; IOL type; axial length; patient age and sex; Nd:YAG capsulotomy and date; and retinal detachment and date.


RESULTS
Phacoemulsification had a lower risk of retinal detachment than intracapsular cataract extraction (ICCE) (0.4% versus 5.4%; P <.001) and extracapsular cataract extraction (ECCE) (0.4% versus 1.6%; P =. 002). Although retinal detachment was significantly associated with Nd:YAG for ECCE (3.1% versus 1.0%; P =.01), no patient in the phacoemulsification group had a retinal detachment after an Nd:YAG treatment. Retinal detachment was strongly associated with axial length of 24.0 mm and greater (P <.001), age of 60 years or less if axial length was 24.0 mm or greater (for ECCE, P =.001; for phacoemulsification, P =.01) and sex; that is, male (for ECCE, P =. 04; for phacoemulsification, P =.02). Regarding IOL styles the Surgidev B20/20 (P <.001) and AcrySof MA60 (P <.001) had significantly lower Nd:YAG rates, while the Cilco UPB 320 GS had a significantly higher Nd:YAG rate (P <.001).


CONCLUSIONS
Cataract surgical approach and IOL style significantly affect Nd:YAG and retinal detachment rates. Being a man, being 60 years or younger, and especially having an axial length of 24.0 mm or greater were associated with detachment. Some Nd:YAG approaches may not put the patient at increased risk for retinal detachment.
Olsen
G
G
Department of Ophthalmology and Visual Sciences, John Moran Eye Center, Salt Lake City, UT 84132, USA.
Olson
R J
RJ
D002387:Cataract Extraction / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053685:Laser Therapy; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012163:Retinal Detachment / Q000209:etiology*; D012307:Risk Factors; D014792:Visual Acuity