Risk of Retinal Detachment after Cataract Extraction, 1980–2004: A Population-Based Study
Presented in part at: American Ophthalmological Society Annual Meeting, May 24, 2006, Half Moon Bay, California.
Received 5 April 2006; accepted 12 May 2006. published online 25 August 2006.
Purpose
To estimate the long-term cumulative risk of retinal detachment (RD) after cataract extraction (CE).
Design
Retrospective cohort study and nested case–control study.
Participants
All residents of Olmsted County, Minnesota who had CE from 1980 through 2004 (10 256 CEs in 7137 residents) and were diagnosed subsequently with RD in the same period. Two controls chosen from the primary cataract surgery cohort were matched to each RD case by age, gender, and duration of follow-up.
Methods
Cases were identified through the Rochester Epidemiology Project databases. Records were reviewed to confirm case status and ascertain risk factor information. The observed probability of RD after CE was estimated using the Kaplan–Meier method. A cumulative probability ratio of RD after CE was determined by comparing the observed probability of RD and the expected probability of RD in residents without CE. Logistic regression models assessed differences between cases and controls.
Main Outcome Measures
Probability of and risk factors associated with RD after CE.
Results
Eighty-two cases of RD were identified. The cumulative probability of RD increased in a nearly linear manner over the 25-year study period. At 1, 5, 10, 15, and 20 years after extracapsular CE (ECCE) and phacoemulsification, cumulative probabilities of RD were 0.27%, 0.71%, 1.23%, 1.58%, and 1.79%, respectively. There was no significant difference in the probability of RD after ECCE when compared with phacoemulsification (P = 0.13). The cumulative probability ratio of RD at 20 years after ECCE and phacoemulsification remained 4.0-fold (95% confidence interval, 2.6–5.4) higher than would be expected in a similar group of residents not undergoing CE (P<0.001). Male gender, younger age, myopia, increased axial length, and posterior capsular tear were associated significantly with RD (P<0.01).
Conclusions
The cumulative risk of RD after ECCE and phacoemulsification is increased for up to 20 years after surgery.
1Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota.
2Department of Health Sciences, Mayo Clinic College of Medicine, Rochester, Minnesota.
Correspondence to Jay C. Erie, MD, Department of Ophthalmology, Mayo Clinic College of Medicine, 200 1st Street SW, Rochester, MN 55905.
Manuscript no. 2006-406.
Supported in part by Research to Prevent Blindness, Inc., New York, New York, and the Mayo Foundation, Rochester, Minnesota.
No author has a financial or proprietary interest in any materials or methods mentioned.
ABSTRACT