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Occurrence of Retinal Detachment After Cataract Surgery

Occurrence of Retinal Detachment After Cataract Surgery. Peter Jeppesen MD, PhD and Thomas K. Olsen, MD, DMSc Department of Ophthalmology Århus University Hospital Denmark Financial interest: Thomas Olsen is a paid consultant to Carl Zeiss Meditec

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Occurrence of Retinal Detachment After Cataract Surgery

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  1. Occurrence of Retinal Detachment After Cataract Surgery Peter Jeppesen MD, PhD and Thomas K. Olsen, MD, DMSc Department of Ophthalmology Århus University Hospital Denmark Financial interest: Thomas Olsen is a paid consultant to Carl ZeissMeditec Peter Jeppesen has no financial interest in this presentation

  2. Purpose • To estimate the cumulative risk of retinal detachment (RD) after routine cataract surgery by phacoemulsification.

  3. Methods (1) • Material • 12.222 consecutive surgeries in 7.856 patients from 2000 to 2005 • IOLs • 94% foldable hydrophobic acrylic (ALCON Acrysof) • 6% One-piece PMMA (AMO CeeOn 812c or similar) • 0.2% Anterior chamber (Pharmacia 351C) • All caseswithretinaldetachment (RD) wereidentified through our electronic patient records and through the Danish National Patient Registry (LPR). LPR provided a list of all patients from the cohort of cataract surgeries which at some time had been given the diagnosis of retinal detachment. • 1251 visits in our clinic due to retinal detachment and furthermore 13 patients treated for retinal detachment elsewhere were included.

  4. Methods (2) • Cross matching of the two lists • Review of each case record • Verification of the diagnose • Comorbidity • Parameters noted • Age • Gender • Axiallength • Complicationsduringcataractsurgery • Post-operative Nd:YAGcapsulotomy • Time interval betweencataractsurgery and RD

  5. Results (1) Clinical data of the group of retinal detachment (RD) after cataract surgery compared with the normal group of cataract operated patients. *) RD group different from normal cataract group (p < 0.001 by unpaired t-test) **) RD group different from normal cataract group (p < 0.001 by chi-square test)

  6. Results (2)Kaplan-Meier Survival Curves Gender Female Male The time interval between cataract surgery and RD varied from 0.03 to 77.8 months (mean 26.5 months).

  7. Results (3) The distribution of the axial length in the RD group as compared to the normal cataract population

  8. Results (4) When analyzed for the axial length dependency, the incidence of RD was found to increase from its lowest value of 0.18 % in the normal and shorter eyes (axial length < 24 mm) to its highest value of about 2.3 % in the longer eyes (27 – 28 mm of axial length)

  9. Results (5) When analyzed for the age dependency, the incidence of RD was found to be highest among the subjects in the fifth decade ( 2.1 % ) and to decrease in the older age groups.

  10. Results (6) • The incidence of Nd:YAG capsulotomy was 3 (6.3 %) cases in the RD group as compared to 1159 (9.5 %) in the normal cataract group (p > 0.05) • Seven of the RD cases were found to have a history of previous ocular trauma and 2 cases were diagnosed with subluxation of the lens of unknown cause

  11. Conclusion • As compared to the average cataract group, the group of RD following cataract surgery was characterized by: • younger mean age (60.5 vs 73.7 years) • male gender (58.3 % vs 34.8 %), • longer axial lengths (24.56 vs 23.25 mm) • higher frequency of surgical complications (10.4 % vs 1.8 %) (p < 0.001) • not a higher frequency of Nd:YAGcapsulotomy (p > 0.05) • The cumulative risk of RD after lens surgery was about 2.4 times the natural incidence but seems to be lower than that of older reports.

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