Article

Late increased risk of retinal detachment after cataract extraction.

Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
American journal of ophthalmology (impact factor: 3.83). 10/2009; 149(1):113-9. DOI:10.1016/j.ajo.2009.08.006 pp.113-9
Source: PubMed

ABSTRACT To identify the possibility and characteristics of late increase in the cumulative risk of retinal detachment (RD) after cataract extraction and intraocular lens (IOL) implantation.
Prospective cohort study of submitted claims records.
Records of 9388 consecutive insurance beneficiaries who underwent cataract extraction and IOL implantation between August 1, 1999 and December 1, 2001 were collected from the Bureau of National Health Insurance. Data included each patient's demographic characteristics, medical history, refractive status, axial length (AL), type of cataract extraction, and intraoperative complications. Posterior capsulotomy, diagnostic procedures, and treatment for retinal complications and other ocular diseases were identified by codes from physicians' billing records yearly to the end of 2007.
The cumulative 8-year RD rate was 2.31% at the end of the follow-up. Factors with significant effect on the risk of RD included being male and younger, having an increased AL, and having a history of RD in the fellow eye. The cumulative risk of RD after cataract extraction and IOL implantation increased with time. There was a significantly late increased risk of RD after 4 years in the group of patients with high myopia (AL, > 26 mm; P = .026), but not in the group of moderate myopia (AL 23 to 26 mm, P = .068) or nonmyopia (AL, < 23 mm; P = .066). The late increase appeared in male group, but not in the female group, even in those with high myopia (male, P = .042; female, P = .068).
Our study showed that patients with high myopia may be at increased risk for late pseudophakic RD after 4 years, especially in males.

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    Article: Risk for Retinal Detachment After Phacoemulsification: A Whole-Population Study of Cataract Surgery Outcomes
    Antony Clark, Nigel Morlet, Jonathon Q Ng, David B Preen, Bsc ( Hons, James B Semmens
    [show abstract] [hide abstract]
    ABSTRACT: Objectives: To estimate the long-term cumulative in-cidence of and risk factors for retinal detachment (RD) after phacoemulsification using linked administrative medical data. Methods: We used the Western Australian Data Link-age System to identify patients who underwent phaco-emulsification in Western Australia between January 1989 and December 2001. Retinal detachment cases were those patients requiring admission for RD surgery after phaco-emulsification that were validated by medical record re-view. Kaplan-Meier analysis was used to calculate a cu-mulative incidence. Cox proportional hazards regression modeling was used to determine the association be-tween RD and risk factors, including patient demograph-ics and operative and hospital factors. Some important risk factors, including axial length and Nd:YAG laser cap-sulotomy, were not examined. Results: We identified 237 RD cases following 65 055 phacoemulsification procedures, with a 10-year cumu-lative incidence of 0.68% (95% CI, 0.56%-0.83%). Sig-nificant risk factors were year of surgery (hazard ratio [HR], 0.43; 95% CI, 0.28-0.66 [1999-2001 compared with 1989-1993] for each 5-year period after 1985), age younger than 60 years (3.76; 2.83-5.00), male sex (1.91; 1.45-2.51), and anterior vitrectomy (27.60; 19.27-39.52). Hospital location, patient rural or remote local-ity, hospital cataract surgery volume, failed intraocular lens insertion, length of stay, and patient insurance sta-tus were not significantly associated with RD. Conclusions: Risk for RD after phacoemulsification has almost halved for each 5-year period since its adoption in the mid 1980s. Younger patient age and male sex at surgery significantly increased risk for RD. Phacoemulsification re-quiring anterior vitrectomy vastly increased risk for RD.
    Archives of Ophthalmology 07/2012; 130(7):882-888. · 3.71 Impact Factor
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    Dataset: Frequency of retinal detachment after cataract surgery in highly myopic patients
    Al Muammar, Dora Al-Harkan, Sultan Al-Rashidy, Sarah Al-Suliman, Ahmed Mousa, Phd Msc
    [show abstract] [hide abstract]
    ABSTRACT: p<0.0001(‫إحصائي‬ ‫بشكل‬ ً ‫مرتفعا‬ ‫الشبكية‬ ‫متزق‬ ‫معدل‬ ‫وكان‬ ‫العملية‬ ‫بعد‬ ‫الشبكية‬ ‫بتمزق‬ ‫مجموعة‬ ‫من‬ ‫أكثر‬)]2.8%[ 10(‫احلالة‬ ‫مجموعة‬ ‫لدى‬ ‫كما‬ .)p=0.007(‫إحصائي‬ ‫بشكل‬)]0.4%[ 2(‫التحكم‬ ‫الشبكية‬ ‫لتمزق‬ ‫الوحيد‬ ‫اإلحصائي‬ ‫املؤثر‬ ‫العامل‬ ‫احملور‬ ‫طول‬ ‫كان‬ .)p=0.019(‫املتغيرات‬ ‫تسوية‬ ‫بعد‬)p=0.005(
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Keywords

4 years
 
9388 consecutive insurance beneficiaries
 
August 1
 
claims records
 
cumulative 8-year RD rate
 
cumulative risk
 
December 1
 
female group
 
increased AL
 
intraocular lens
 
IOL implantation
 
male group
 
moderate myopia
 
National Health Insurance
 
nonmyopia
 
physicians' billing records yearly
 
Posterior capsulotomy
 
Prospective cohort study
 
pseudophakic RD
 
significant effect