Incidence, Risk Factors, and Impact of Age on Retinal Detachment after Cataract Surgery in France: A National Population Study.
OBJECTIVE
To assess the incidence, risk factors, and impact of age on retinal detachment (RD) after cataract surgery.


METHODS
Cohort study.


METHODS
All patients older than 40 years of age who underwent a primary cataract surgery in France between January 2009 and December 2012.


METHODS
A Cox proportional-hazard regression model was used to analyze risk factors of RD after cataract surgery.


METHODS
Risk factors of RD after cataract surgery.


RESULTS
Over 4 years, 2680167 eyes in 1787021 patients (59.4% women; mean age, 73.9±9.5 years) underwent cataract surgery. A total of 11 424 patients experienced RD after cataract surgery, with an estimated risk of 0.99% at 4 years after surgery. The odds ratio associated with increased risk of RD was 3.87 (95% confidence interval [CI], 3.79-3.95) for cataract surgery itself. The multiadjusted hazard ratio (HR) associated with increased risk of RD was 5.22 (95% CI, 5.05-5.39) for patients 40 to 54 years of age, 3.69 (95% CI, 3.60-3.79) for those 55 to 64 years of age, and 1.98 (95% CI, 1.93-2.03) for those 65 to 74 years of age as compared with those 75 years of age or older. Retinal detachment was associated with high myopia (HR, 6.12; 95% CI, 5.84-6.41), vitrectomy for perioperative capsular rupture (HR, 4.36; 95% CI, 4.07-4.68), history of eye trauma (HR, 3.98; 95% CI, 3.69-4.30), extracapsular extraction (HR, 3.11; 95% CI, 2.94-3.30), male gender (HR, 2.39; 95% CI, 2.35-2.44), and history of diabetes (HR, 1.18; 95% CI, 1.15-1.21). In myopic patients, the multiadjusted HR associated with increased risk of RD was 25.02 (95% CI, 24.76-25.18) for patients 40 to 54 years of age, 20.37 (95% CI, 20.21-20.53) for those 55 to 64 years of age, and 17.05 (95% CI, 16.85-17.25) for those 65 to 74 years of age as compared with nonmyopic patients 75 years of age or older.


CONCLUSIONS
We provide a hierarchy of risk factors for RD onset: high myopia, young age, capsular rupture, history of eye trauma, extracapsular extraction technique, male gender, and diabetes. Young age was an additional risk factor in myopic patients.
Inserm 1061, Montpellier, France; University of Montpellier, Montpellier, France; Service d'ophtalmologie, Hôpital Gui de Chauliac, Montpellier, France. Electronic address: vincent.daien@gmail.com.
Vincent
V
Daien
Biostatistics Department, Regional Agency of Health, Montpellier, France.
Annick
A
Le Pape
Biostatistics Department, Regional Agency of Health, Montpellier, France.
Didier
D
Heve
Inserm 1061, Montpellier, France.
Isabelle
I
Carriere
University of Montpellier, Montpellier, France; Service d'ophtalmologie, Hôpital Gui de Chauliac, Montpellier, France.
Max
M
Villain
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018918:Phacoemulsification; D011183:Postoperative Complications; D016016:Proportional Hazards Models; D012163:Retinal Detachment / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors