Longterm incidence of rhegmatogenous retinal detachment and survival in a defined population undergoing standardized phacoemulsification surgery

Abstract

. Purpose: To determine the longterm risk of pseudophakic retinal detachment (PRD) in a defined population undergoing standardized phacoemulsification surgery at a single centre. Design: We carried out a register‐based, retrospective, consecutive, uncontrolled study. All 6352 eyes that underwent cataract surgery at our institution during the years 1996–1998 were included in the study. The main outcome measure was the incidence of surgery for PRD. Methods: Cataract‐operated eyes were identified by a search in the local hospital registry. Eyes that subsequently underwent surgery for PRD were identified by a search in the Danish Patients Registry (LPR). Follow‐up ended by 31 December 2003. Eyes in patients who died before that date were censored. Results: The 8‐year cumulated incidence of PRD after phacoemulsification was 0.93 per eye (95% CI 0.65–1.33). This is 8.77 (95% CI 7.12–10.72) times higher than expected in eyes that do not undergo cataract surgery. The incidence rate for retinal detachment was significantly higher in pseudophakic eyes than in the background population for at least 6 years after surgery. Patient mortality was slightly increased for men, but no different for women from that of the background population. Conclusion: For eyes undergoing phacoemulsification surgery, the cumulated incidence of PRD continues to increase for at least 8 years after surgery. Comparison of the cumulated incidence of PRD between different studies requires equal lengths of follow‐up.

Tinklainės Atšokos Rizikos Veiksniai Po Kataraktos Operacijų

“…Nors lyties įtaka diskutuotina, vis dėlto didžioji dalis autorių sutinka, kad lytis turi įtakos pseudofakinei TA ir būdingesnė vyrams [5,7,8,10]. Remiantis minėtų autorių teiginiais pasitvirtinto didesnis pseudofakinių TA atvejų dažnis vyrams.…”

“…Suskirsčius tiriamuosius į grupes pagal laiką nuo kataraktos operacijos iki TA, gauti statistiškai reikšmingi skirtumai tarp grupių, tačiau literatūroje aprašomų tendencijų nepastebima. Didžiausia rizika pseudofakinei TA vystytis pirmaisiais metais [8,9,10,11] nepastebima, intervalų perėjimas nenuoseklus, banguojantis ir pasiekia piką 0,5-1 ir 2-5 metų grupėse. Šioje studijoje daugiau kaip pusei pacientų pseudofakinė TA išsi-vystė per pirmuosius dvejus metus po kataraktos operacijos.…”

Rhegmatogenous retinal detachment: are we making progress?

“…Furthermore, the risk of new retinal breaks and ⁄ or recurrent RD might be elevated after cataract surgery in these eyes (Grand 2003). The data presented by Boberg-Ans et al (2006) in this issue of the journal underscore the fact that retinal complications from cataract surgery may occur several years after the operation. Hence, a fair comparison between scleral buckling surgery (without the use of intraocular gas) and pneumatic retinopexy or primary vitrectomy in phakic eyes requires lengthy follow-up.…”

“…The paper by BobergAns et al (2006) presented in this issue of the journal provides some hard data concerning the longterm incidence of pseudophakic RD after modern, standardized phacoemulsificaton surgery. This register-based study found that the risk of RD in an eye operated for cataract was elevated for at least 6 years postoperatively, during which time the cumulated number of observed RD cases was more than nine times that of the cumulative background incidence (Boberg-Ans et al 2006). The study utilized the unique Danish Patient Registry, which allowed complete follow-up of the end-point: surgery for RD at a hospital within Denmark.…”

“…This issue of Acta includes three papers on rhegmatogenous RD (Abouzeid & Wolfensberger 2006;Boberg-Ans et al 2006;Saw et al 2006).…”