Risk factors for retinal detachment after cataract surgery: a case-control study.
OBJECTIVE
To determine risk factors for rhegmatogenous retinal detachment after cataract surgery.


METHODS
Retrospective case-control study.


METHODS
A consecutive series of 63298 cataract surgery procedures in 45520 patients performed between August 1994 and March 2003 was identified. After exclusions for incomplete data, 249 cases of pseudophakic retinal detachment were matched with 845 controls that had cataract surgery on the same day, but without subsequent retinal detachment.


METHODS
Details were extracted from the clinical records. A conditional logistic regression model for matched case-control groups was used. Multiple regression analysis was performed to estimate the odds ratio for each variable, with adjustment for the effects of other variables selected from the candidate pool.


METHODS
Occurrence of rhegmatogenous retinal detachment.


RESULTS
The major risk factors (odds ratio [OR], 95% confidence interval [CI], P value) for detachment were posterior capsule tear (OR, 19.9; CI, 10.8-36.7; P<0.001), zonule dehiscence (OR, 12.4; CI, 3.8-41.2; P<0.001), retinal detachment in fellow eye (OR, 12.3; CI, 5.2-29.1; P<0.001), axial length >23 mm (OR, 3.2; CI, 2.0-5.0; P<0.001), and male gender (OR, 2.2; CI, 1.4-3.3; P<0.001). For patients aged >64 years, the odds ratio was linearly reduced for each subsequent decade. Differences in the surgical technique (i.e., phacoemulsification vs. extracapsular extraction), type of anesthetic, prior glaucoma, or subsequent neodymium:yttrium-aluminum-garnet laser posterior capsulotomy were not significantly related to retinal detachment. Approximately 37% (CI, 35%-38%) of retinal detachment was attributable to posterior capsule tear.


CONCLUSIONS
Patient characteristics rather than surgical complications constitute the major risks factors for retinal detachment after cataract surgery.
Moorfields Eye Hospital, London, England, United Kingdom.
Stephen J
SJ
Tuft
Darwin
D
Minassian
Paul
P
Sullivan
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002387:Cataract Extraction; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications; D019591:Pseudophakia / Q000209:etiology*; D012163:Retinal Detachment / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors