Late Increased Risk of Retinal Detachment After Cataract Extraction

Purpose

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.

Design

Prospective cohort study of submitted claims records.

Methods

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.

Results

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).

Conclusions

Our study showed that patients with high myopia may be at increased risk for late pseudophakic RD after 4 years, especially in males.