title: Patterns of pseudophakic retinal detachment in a referral tertiary care center and the need for improving cataract surgical training.
abstract: OBJECTIVE
  To determine the risk factors associated with development of rhegmatogenous retinal detachment (RRD) in patients undergoing different types of cataract surgery.
  
  
  METHODS
  Records of 200 patients presenting with pseudophakic retinal detachment (PRD) between January 2012 and July 2013 at a tertiary care center were reviewed. Duration and type of cataract surgery (phacoemulsification, extracapsular cataract extraction [ECCE], and small-incision cataract surgery [SICS]) and history of YAG capsulotomy with risk factors were recorded. Presence or absence of these risk factors was analyzed and their association with type of cataract surgery was evaluated.
  
  
  RESULTS
  Of these 200 patients, 137 were male and 63 were female. The mean age of the patients was 55.19 ± 12.60 years and mean duration of cataract surgery to diagnosis of RRD was 8.64 ± 5.15 months. Most patients underwent phacoemulsification (45%), followed by ECCE (31.5%) and SICS (23.5%). Most of the patients with PRD had complicated cataract surgery with intraocular lens (IOL) in sulcus in 63%, anterior chamber IOL in 3%, and aphakia in 0.5%. There was no difference among the 3 types of surgery performed in mean presenting visual acuity, duration between cataract surgery and YAG capsulotomy, or number of posterior chamber IOLs. Incidence of posterior capsular rent (p = 0.02) and presence of vitreous in anterior chamber (p = 0.01) were significantly higher for patients with retinal detachment (RD) who underwent SICS.
  
  
  CONCLUSIONS
  Many risk factors are associated with RD development after cataract surgery. More stringent efforts at improving the quality of cataract surgical training are likely to help in reducing the risk of PRD.
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - India.
authors.forename: Meenakshi
authors.initials: M
authors.lastname: Wadhwani
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - India.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Venkatesh
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - India.
authors.forename: Varun
authors.initials: V
authors.lastname: Gogia
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - India.
authors.forename: Shikha
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - India.
authors.forename: Yograj
authors.initials: Y
authors.lastname: Sharma
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi - India.
authors.forename: Veena
authors.initials: V
authors.lastname: Pandey
mesh_terms: D000328:Adult; D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects* / Q000193:education* / Q000379:methods; D002983:Clinical Competence / Q000592:standards; D004503:Education, Medical, Graduate / Q000592:standards; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000592:standards; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D058996:Quality Improvement; D012163:Retinal Detachment / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D014792:Visual Acuity / Q000502:physiology