1
|
Schöneberger V, Tahmaz V, Menghesha L, Lüke JN, Cursiefen C, Schaub F, Bachmann BO. Retinal Detachment Rates After Uncomplicated DMEK Versus Cataract Surgery Combined (Triple-)DMEK. Cornea 2024:00003226-990000000-00541. [PMID: 38692685 DOI: 10.1097/ico.0000000000003554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/18/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE To evaluate the rate of and risk factors for rhegmatogenous retinal detachment (RRD) after Descemet membrane endothelial keratoplasty (DMEK) either alone or in combination with cataract surgery. DESIGN Retrospective analysis of prospective database. METHODS Consecutive eyes with Fuchs endothelial corneal dystrophy (FECD) that received DMEK surgery with a minimum follow-up of 1 year between July 2011 and January 2021 at the Department of Ophthalmology at the University of Cologne were analyzed. Exclusion criteria were complicated history including repeat DMEK within 1-year, previous retinal or glaucoma surgery, complicated phacoemulsification, congenital cataract, history of trauma. RESULTS From 3858 consecutive DMEKs, 1961 patients were identified suitable for analysis. 846 (43.1%) were pseudophakic DMEK, 91 (4.6%) phakic DMEK and 1,024 (52.2%) combined with cataract surgery. RRD occurred in 13 eyes (12 patients). Within two years after DMEK RRD occurred in 0.49% and 0.47% after DMEK and DMEK with cataract surgery, respectively. Mean age of 59.24 ± 8.42 years with subsequent RRD was significantly lower than overall 68.81 ± 9.89 years (t-test two-tailed; p < 0.001). The spherical equivalent was -4.69 ± 3.98 D (range -9.00 to 0.5) in RRD after pseudophakic DMEK compared to -2.79 ± 3.54 D (range -7.5 to 0.75) in combined procedures. Re-bubbling had no influence on RRD rate. CONCLUSIONS DMEK alone or in combination with cataract surgery showed similar postoperative RRD rates in the first two years, generally in the range of pseudophakic RRDs. Risk factors such as myopia and younger age could be identified. Re-bubbling has no influence on RRD rates.
Collapse
Affiliation(s)
- Verena Schöneberger
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and
| | - Volkan Tahmaz
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and
| | - Leonie Menghesha
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and
| | - Jan Niklas Lüke
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and
| | - Claus Cursiefen
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and
| | - Friederike Schaub
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and
- Department of Ophthalmology, University Medical Center Rostock, University of Rostock, Rostock, Germany
| | - Björn O Bachmann
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; and
| |
Collapse
|
2
|
Rodríguez-Calvo-de-Mora M, Rocha-de-Lossada C, Rodríguez-Vallejo M, Zamora-de-la-Cruz D, Fernández J. Retinal detachment after refractive lens exchange: A narrative review. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:507-520. [PMID: 37364678 DOI: 10.1016/j.oftale.2023.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 06/01/2023] [Indexed: 06/28/2023]
Abstract
Refractive lens exchange (RLE) allows to correct ametropias and presbyopia by replacing the crystalline lens with an extended depth of focus or multifocal intraocular lens (IOL). Retinal detachment (RD) is one of the most serious adverse events after RLE. This study aimed to review the evidence related to the risk of RD after RLE and clinical outcomes. A search using PubMed and a snowball search approach was conducted to identify articles and case reports. According to the literature, the risks of RD should be considered in patients <60 years old with axial lengths >23 mm. Only nine articles reported visual acuity (VA) after RD in RLE, and only 25% of eyes had a VA > 20/40. Considering that the decrease in VA might be uniform for all types of IOLs after RD, surgeons should focus on selecting the patient to prevent RD rather than on a particular IOL optical design based on the potential risk of DR.
Collapse
Affiliation(s)
- M Rodríguez-Calvo-de-Mora
- Qvision, Departamento de Oftalmología, VITHAS Almería Hospital, Almería, Spain; Departamento de Oftalmología, VITHAS Málaga, Málaga, Spain; Departamento de Oftalmología, Hospital Regional Universitario Málaga, Málaga, Spain.
| | - C Rocha-de-Lossada
- Qvision, Departamento de Oftalmología, VITHAS Almería Hospital, Almería, Spain; Departamento de Oftalmología, VITHAS Málaga, Málaga, Spain; Departamento de Oftalmología, Hospital Regional Universitario Málaga, Málaga, Spain; Departamento de Cirugía, Área de Oftalmología, Universidad de Sevilla, Sevilla, Spain
| | - M Rodríguez-Vallejo
- Qvision, Departamento de Oftalmología, VITHAS Almería Hospital, Almería, Spain
| | - D Zamora-de-la-Cruz
- Departamento de Segmento Anterior, Instituto de Oftalmología Fundación Conde de Valenciana, Mexico City, Mexico; Departamento de Segmento Anterior, Hospital Mexiquense de Salud Visual, ISEM, Naucalpan de Juárez, Mexico
| | - J Fernández
- Qvision, Departamento de Oftalmología, VITHAS Almería Hospital, Almería, Spain
| |
Collapse
|
3
|
Yao Y, Lu Q, Wei L, Cheng K, Lu Y, Zhu X. Efficacy and complications of cataract surgery in high myopia. J Cataract Refract Surg 2021; 47:1473-1480. [PMID: 33929806 DOI: 10.1097/j.jcrs.0000000000000664] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/20/2021] [Indexed: 11/26/2022]
Abstract
To evaluate the efficacy and complications of cataract surgery in high myopia, a comprehensive search query was conducted from January 2000 to August 2020. A total of 19 586 highly myopic eyes from 28 studies were included. Modern cataract surgery turns out efficacious in highly myopic eyes with significant improvement of visual acuity. However, phacoemulsification-related complications such as posterior capsular rupture (3.91%, 95% CI, 1.98%-6.37%), retinal detachment (1.74%, 95% CI, 1.36%-2.15%), progressed myopic traction maculopathy (5.07%, 95% CI, 1.80%-9.37%), capsular contraction syndrome (2.1%), intraocular lens dislocation (0.58%), and transient intraocular pressure elevation (28.15%, 95% CI, 20.29%-36.70%) occurred more frequently in the highly myopic population. Separate analyses were also conducted based on follow-up period. In conclusion, modern cataract surgery was effective for highly myopic cataract patients, whereas careful precautions and sufficient follow-ups were of great value because of higher incidences of intraoperative and postoperative complications.
Collapse
Affiliation(s)
- Yunqian Yao
- From the Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China; Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | | | | | | | | | | |
Collapse
|
6
|
Qureshi MH, Steel DHW. Retinal detachment following cataract phacoemulsification-a review of the literature. Eye (Lond) 2020; 34:616-631. [PMID: 31576027 PMCID: PMC7093479 DOI: 10.1038/s41433-019-0575-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/25/2019] [Accepted: 07/11/2019] [Indexed: 11/09/2022] Open
Abstract
A link between cataract surgery and rhegmatogenous retinal detachment (RRD) has long been considered. Indeed, pseudophakic retinal detachment (PPRD) forms a substantial and increasing proportion of RRD. We reviewed the literature to answer the following questions: what is the incidence of PPRD in eyes following phacoemulsification cataract surgery and how does its risk change over time following surgery? We also sought to assess how the risk is modified by intraoperative factors (operative complications, surgeon grade, subsequent laser capsulotomy), intrinsic eye-related factors (laterality, myopia, previous RRD, previous trauma, previous PVD) and patient factors (sex, age, ethnicity, affluence, systemic comorbidities). Secondarily we asked how the incidence of PPRD after phacoemulsification compares with the RRD incidence in the general population and how identified risk factors contribute to the pathophysiology of PPRD. A search of the Medline and Ovid databases was conducted for relevant publications from 1990 onwards using defined search terms with pre planned inclusion and exclusion criteria. The 10-year PPRD incidence after phacoemulsification was identified as being between 0.36 and 2.9%. This decreases over time to 0.1-0.2% annually but remains above the general population. The PPRD risk is further elevated by (in order of decreasing effect) intraoperative vitreous loss, increasing axial length, younger age, male sex and trainee operating surgeons. The PPRD risk after phacoemulsification is approximately ten times the general population's RRD risk. This risk is modified by the interplay of a hierarchy of risk factors, of which intraoperative vitreous loss, myopia, age and sex have the biggest effect.
Collapse
Affiliation(s)
- M Hamza Qureshi
- Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, UK
- Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne, UK
| | - David H W Steel
- Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, UK.
- Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland, UK.
| |
Collapse
|
7
|
Tassignon MJ, Van den Heurck JJI, Boven KBM, Van Looveren J, Wouters K, Bali E, Ní Dhubhghaill S, Mathysen DGP. Incidence of rhegmatogenous retinal detachment after bag-in-the-lens intraocular lens implantation. J Cataract Refract Surg 2015; 41:2430-7. [PMID: 26703493 DOI: 10.1016/j.jcrs.2015.05.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 04/13/2015] [Accepted: 05/18/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To determine the incidence of rhegmatogenous retinal detachment (RRD) and associated risk factors after phacoemulsification and bag-in-the-lens intraocular lens (IOL) implantation. SETTING Antwerp University Hospital, Department of Ophthalmology, Antwerp, Belgium. DESIGN Prospective cohort study. METHODS All consecutive bag-in-the-lens IOL implantations performed between January 2001 and December 2007 were included, with the exception of combined procedures and IOL exchanges. The retinal detachment (RD) incidence was studied in the total cohort, in a subgroup of patients with 1 to 5 years of follow-up, and finally in the group remaining after exclusion of all risk factors except gender. RESULTS RD after bag-in-the-lens IOL implantation in 1323 eyes with an average follow-up of 44.75 months (range 0 to 152 months) was found in 19 eyes (1.44%). The 1-year RD incidence was 0.49% (5 RD cases in 1024 eyes) (0.00% in patients without risk factors). The 2-year cumulative RD incidence was 0.84% (9 RD cases in 931 eyes; 0.15% without risk factors). Four clinically significant risk factors were confirmed: male gender, young age at time of surgery (<60 years), axial myopia (axial length ≥25 mm), and history of contralateral RD in the total cohort. CONCLUSION The RRD incidence following bag-in-the-lens IOL implantation was comparable to that seen after lens-in-the-bag (LIB) implantation. The wide variation in study design in the literature precludes direct comparison, so there is a need for standardization in evaluating RRD incidence after cataract surgery. Future prospective studies should consider patients with and without risk factors (except gender) separately. FINANCIAL DISCLOSURE Prof. dr. M.J. Tassignon has intellectual property rights to the bag-in-the-lens intraocular lens (U.S. patent 6 027 531; EU patent 009406794; PCT/120268), which is licensed to Morcher GmbH, Stuttgart, Germany.
Collapse
Affiliation(s)
- Marie-José Tassignon
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium
| | - Jonas J I Van den Heurck
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium
| | - Kim B M Boven
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium
| | - Jan Van Looveren
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium
| | - Kristien Wouters
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium
| | - Ernesto Bali
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium
| | - Sorcha Ní Dhubhghaill
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium
| | - Danny G P Mathysen
- From the Department of Ophthalmology (Tassignon, Van den Heurck, Boven, Van Looveren, Dhubhghaill, Mathysen) Antwerp University Hospital, Edegem, Antwerp, Belgium; Faculty of Medicine and Health Sciences (Tassignon, Van den Heurck, Boven, Jan Van Looveren, Wouters, Mathysen), University of Antwerp, Wilrijk, Antwerp, Belgium; Department of Scientific Coordination-Biostatistics (Wouters), Antwerp University Hospital, Edegem, Antwerp, Belgium; Department of Ophthalmology (Bali), Clinique du Parc Léopold, Brussels, Belgium.
| |
Collapse
|