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Ophthalmology. 2015 Nov;122(11):2179-85. doi: 10.1016/j.ophtha.2015.07.014. Epub 2015 Aug 13.

Incidence, Risk Factors, and Impact of Age on Retinal Detachment after Cataract Surgery in France: A National Population Study.

Author information

1
Inserm 1061, Montpellier, France; University of Montpellier, Montpellier, France; Service d'ophtalmologie, Hôpital Gui de Chauliac, Montpellier, France. Electronic address: vincent.daien@gmail.com.
2
Biostatistics Department, Regional Agency of Health, Montpellier, France.
3
Inserm 1061, Montpellier, France.
4
University of Montpellier, Montpellier, France; Service d'ophtalmologie, Hôpital Gui de Chauliac, Montpellier, France.

Abstract

PURPOSE:

To assess the incidence, risk factors, and impact of age on retinal detachment (RD) after cataract surgery.

DESIGN:

Cohort study.

PARTICIPANTS:

All patients older than 40 years of age who underwent a primary cataract surgery in France between January 2009 and December 2012.

METHODS:

A Cox proportional-hazard regression model was used to analyze risk factors of RD after cataract surgery.

MAIN OUTCOME MEASURES:

Risk factors of RD after cataract surgery.

RESULTS:

Over 4 years, 2680167 eyes in 1787021 patients (59.4% women; mean age, 73.9±9.5 years) underwent cataract surgery. A total of 11 424 patients experienced RD after cataract surgery, with an estimated risk of 0.99% at 4 years after surgery. The odds ratio associated with increased risk of RD was 3.87 (95% confidence interval [CI], 3.79-3.95) for cataract surgery itself. The multiadjusted hazard ratio (HR) associated with increased risk of RD was 5.22 (95% CI, 5.05-5.39) for patients 40 to 54 years of age, 3.69 (95% CI, 3.60-3.79) for those 55 to 64 years of age, and 1.98 (95% CI, 1.93-2.03) for those 65 to 74 years of age as compared with those 75 years of age or older. Retinal detachment was associated with high myopia (HR, 6.12; 95% CI, 5.84-6.41), vitrectomy for perioperative capsular rupture (HR, 4.36; 95% CI, 4.07-4.68), history of eye trauma (HR, 3.98; 95% CI, 3.69-4.30), extracapsular extraction (HR, 3.11; 95% CI, 2.94-3.30), male gender (HR, 2.39; 95% CI, 2.35-2.44), and history of diabetes (HR, 1.18; 95% CI, 1.15-1.21). In myopic patients, the multiadjusted HR associated with increased risk of RD was 25.02 (95% CI, 24.76-25.18) for patients 40 to 54 years of age, 20.37 (95% CI, 20.21-20.53) for those 55 to 64 years of age, and 17.05 (95% CI, 16.85-17.25) for those 65 to 74 years of age as compared with nonmyopic patients 75 years of age or older.

CONCLUSIONS:

We provide a hierarchy of risk factors for RD onset: high myopia, young age, capsular rupture, history of eye trauma, extracapsular extraction technique, male gender, and diabetes. Young age was an additional risk factor in myopic patients.

PMID:
26278859
DOI:
10.1016/j.ophtha.2015.07.014
[Indexed for MEDLINE]
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