Intraocular lens implantation after atopic cataract surgery decreases incidence of postoperative retinal detachment.
OBJECTIVE
To investigate the efficacy of intraocular lens (IOL) implantation in reducing the incidence of postoperative retinal detachment after cataract surgery in patients with atopic dermatitis.


METHODS
Retrospective review.


METHODS
One hundred sixty-nine eyes of 126 patients who underwent cataract surgery for atopic cataract were followed for more than 1 year. None of the eyes previously had a retinal detachment or retinal detachment surgery.


METHODS
The eyes were divided into 132 eyes of 95 patients with an IOL implantation (IOL group) and 37 eyes of 31 patients without an IOL implantation (aphakia group). The postoperative visual acuity and incidence of postoperative retinal detachment were compared between the 2 groups. The effects of the location of the causative retinal breaks, intraoperative posterior capsule rupture, and postoperative posterior capsulotomy on the incidence of retinal detachments were evaluated.


METHODS
The postoperative corrected visual acuity, incidence of postoperative retinal detachment, and influence of intraoperative posterior capsule rupture on the retinal detachment.


RESULTS
The final visual acuity was better than or equal to 20/20 in 128 eyes (97.0%) of the IOL group and in 29 eyes (78.4%) of the aphakia group (P = 0.0007). Retinal detachment after an uncomplicated cataract surgery occurred in 3 eyes (2.3%) of the IOL group and in 8 eyes (25.8%) of the aphakia group (P<0.0001, Mantel-Cox). Two of 3 eyes (66.7%) in the IOL group and 1 of 8 eyes (16.7%) in the aphakia group that later developed a retinal detachment had an intraoperative posterior capsule rupture. Posterior capsulotomy by yttrium-aluminum-garnet laser did not seem to alter the incidence of postoperative retinal detachment in either the IOL (2.0%) or the aphakia group (25.0%).


CONCLUSIONS
The rate of postoperative retinal detachment in eyes with IOL and no intraoperative posterior capsule rupture seems to be low. Intraocular lens implantation with capsular bag fixation may reduce the incidence of postoperative retinal detachment triggered by lens surgery for atopic cataract.
Inoue
Makoto
M
Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. inoshin@sc.itc.keio.ac.jp
Shinoda
Kei
K
Ishida
Susumu
S
Uchida
Atsuro
A
Kurosaka
Daijiro
D
Katsura
Hiroshi
H
Tsubota
Kazuo
K
D000293:Adolescent; D000328:Adult; D019923:Capsulorhexis; D002386:Cataract / Q000209:etiology; D003876:Dermatitis, Atopic / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications; D007903:Lens Capsule, Crystalline / Q000293:injuries; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D012163:Retinal Detachment / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012421:Rupture; D014792:Visual Acuity