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Alshammari AJ, Alqam RA, Aldeej MA, Al-Omair AM, Wazira LA, Shafei JA, Kaki AA, Raffa LH. Retinal Detachment Following Cataract Surgery: A Systematic Review and Meta-analysis of Incidence, Preoperative Risk Factors, and Postoperative Complications. Ophthalmic Surg Lasers Imaging Retina 2024:1-7. [PMID: 39172224 DOI: 10.3928/23258160-20240625-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
Cataract surgery is the most common surgical operation in the developed world, for treating cataracts, currently the leading cause of blindness worldwide. Retinal detachment (RD) is a potentially sight-threatening adverse effect of cataract surgery. The overall RD case numbers are high due to the common practice of cataract surgery. The Medline, Scopus, and Directory of Open Access Journals databases were searched for relevant articles using the keywords (phacoemulsification OR cataract surgery) AND (retinal detachment, detached retina). The included studies involved 5,480,448 patients, where 36,886 had RD (pooled incidence: 0.66 events per 100 patients, 95% CI 0.43 to 1.00). Male patients had significantly higher odds of developing RD than female patients (odds ratio = 1.73, 95% CI 1.68 to 1.78, P < 0.001). The RD incidence rate across locations was not significantly different. RD is one of the most significant complications following cataract surgery. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].
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Gibelalde A, Pinar-Sueiro S, Ibarrondo O, Ruiz Miguel M, Martínez Soroa I, Mendicute J. Characteristics of pseudophakic retinal detachment and risk factors of recurrence. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2024:S2173-5794(24)00092-6. [PMID: 38823449 DOI: 10.1016/j.oftale.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/21/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND The present study was designed to gain knowledge about the prognostic factors and evolution of pseudophakic retinal detachment (PRD) and to analyse the main characteristics of PRD, such as the mean time to retinal detachment following cataract surgery, as well as the clinical factors associated with the risk of recurrence and worse anatomical and functional outcomes. METHODS This was a retrospective monocentric study of 330 patients with PRD who underwent surgery between 2012 and 2020. All patients were pseudophakic and were referred for retinal detachment surgery at Donostia University Hospital (Terciary Hospital, Spain). RESULTS The mean age of the patients at the time of phacoemulsification was 63.06 ± 10.8 years, and 49.09% of them had moderate myopia [axial length (AL) (23.5-26.5 mm)]. In our series, macular detachment was evident in 69.09% (n = 228) of the patients. The mean time that elapsed between phacoemulsification and PRD surgery was 4.04 ± 4.17 years, which was reduced by half in the event of surgical complications (2.24 ± 2.65). The rate of PRD was 28.79%. The anatomical results in terms of retinal reapplication were better with the combination of vitrectomy and scleral buckling (83.1% vs. 70.5%) (p = 0,127) compared with vitrectomy. The variables associated with a higher risk of recurrence were male sex (hazard ratio (HR) = 1.75), macular detachment (HR = 2.00) and the presence of proliferative vitreoretinopathy (PVR) (HR = 3.21). CONCLUSIONS PRD usually occurs within 4 years of phacoemulsification, although it may occur significantly earlier in the event of surgical complications. Macular involvement, PVR, and male sex are all associated with a higher risk of PRD recurrence.
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Affiliation(s)
- A Gibelalde
- Departamento de Oftalmología, Hospital Universitario de Donostia, Donostia-San Sebastián, Gipuzkoa, Spain.
| | - S Pinar-Sueiro
- Departamento de Oftalmología, Hospital Universitario de Donostia, Donostia-San Sebastián, Gipuzkoa, Spain
| | - O Ibarrondo
- Unidad de Investigación AP-OSI, Alto Deba Integrated Health Care Organization, Arrasate-Mondragón, Mondragon, Spain
| | - M Ruiz Miguel
- Departamento de Oftalmología, Hospital Universitario de Donostia, Donostia-San Sebastián, Gipuzkoa, Spain
| | - I Martínez Soroa
- Departamento de Oftalmología, Hospital Universitario de Donostia, Donostia-San Sebastián, Gipuzkoa, Spain
| | - J Mendicute
- Departamento de Oftalmología, Hospital Universitario de Donostia, Donostia-San Sebastián, Gipuzkoa, Spain
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Alio JL, Pederzolli M, Grzybowski A. Refractive lens exchange: What are the red lines? Eur J Ophthalmol 2024; 34:317-322. [PMID: 38062638 DOI: 10.1177/11206721231218909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Practical advancements in phacoemulsification techniques and intraocular lenses and the wide availability of phacoemulsification machines have led refractive lens exchange (RLE) to increase in popularity. Ethical boundaries in RLE have subsequently been pushed to include patients at higher risk of complications. In this editorial, we consider RLE outcomes and complications per type of refractive error, together with preoperative, intraoperative and postoperative ethical obligations for refractive surgeons. In the conclusions section, we propose an algorithm for ethics-guided indications to RLE.
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Affiliation(s)
- Jorge L Alio
- Research and Development Department, VISSUM Miranza, Alicante, Spain
- Division of Ophthalmology, Pathology and Surgery Department, Universidad Miguel Hernández, Alicante, Spain
| | - Matteo Pederzolli
- Department of Ophthalmology, San Raffaele Scientific Institute, Milan, Italy
- Università Vita-Salute San Raffaele, Milan, Italy
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
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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.
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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
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Gibelalde A, Pinar-Sueiro S, Ibarrondo O, Martínez-Soroa I, Mendicute J, Ruiz Miguel M. Are all primary retinal detachments the same? Anatomic and functional differences between phakic and pseudophakic patients. Int J Retina Vitreous 2023; 9:17. [PMID: 36967392 PMCID: PMC10040123 DOI: 10.1186/s40942-023-00455-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Given differences in the pathogenic mechanisms underlying primary retinal detachment (RD) as a function of the status of the lens, the objective was to explore differences between pseudophakic and phakic patients with primary RD. METHODS A retrospective study including 821 patients who underwent surgery for RD [491 cases of phakic and 330 of pseudophakic RD (pRD and psRD, respectively)] in our hospital between 2012 and 2020. RESULTS The mean age was 58.24 ± 12.76 years in the pRD group and 66.87 ± 11.18 years in the psRD group (p = 0.001). There were more men in both groups (70% and 64.23% of pseudophakic and phakic patients, respectively; p = 0.07). The most common location for the RD was superior in both groups (43.94% and 51.93% of pseudophakic and phakic patients, respectively), rates of inferior and total RD were somewhat higher in the psRD group (31.82% and 13.33% in pseudophakic vs 25.25% and 11.0% in phakic patients, p = 0.001). In pseudophakic and phakic patients respectively, macular involvement in 69.09% and 62.73% of cases (p = 0.067). Proliferative vitreoretinopathy was significantly more common in the psRD group (7.88% vs 3.6% in phakic patients, p = 0.01).The rate of final anatomic reattachment differed markedly between groups, with a higher rate in phakic (94.03%) than pseudophakic (87.27%) patients (p = 0.001). CONCLUSIONS The specific pathogenic mechanism involved in psRD seems to be responsible for worse evolution characteristics which are associated with poorer final anatomic and functional outcomes in pseudophakic patients.
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Affiliation(s)
- Ane Gibelalde
- Department of Ophthalmology, Donostia University Hospital, Paseo del Dr Beguiristain sn. San Sebastian, 20014, Donostia San-Sebastian, Gipuzkoa, Spain.
| | - Sergio Pinar-Sueiro
- Department of Ophthalmology, Donostia University Hospital, Paseo del Dr Beguiristain sn. San Sebastian, 20014, Donostia San-Sebastian, Gipuzkoa, Spain
| | - Oliver Ibarrondo
- AP-OSI Research Unit, Alto Deba Integrated Health Care Organization, Mondragon, Spain
| | - Itziar Martínez-Soroa
- Department of Ophthalmology, Donostia University Hospital, Paseo del Dr Beguiristain sn. San Sebastian, 20014, Donostia San-Sebastian, Gipuzkoa, Spain
| | - Javier Mendicute
- Department of Ophthalmology, Donostia University Hospital, Paseo del Dr Beguiristain sn. San Sebastian, 20014, Donostia San-Sebastian, Gipuzkoa, Spain
| | - Miguel Ruiz Miguel
- Department of Ophthalmology, Donostia University Hospital, Paseo del Dr Beguiristain sn. San Sebastian, 20014, Donostia San-Sebastian, Gipuzkoa, Spain
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Muacevic A, Adler JR, Aljambi FA, Alotaibi MA, Alzahrani MA, Subyani AA, Alharbi MM, Aboalola AB, Alnajjar TA. Incidence and Risk Factors for Retinal Detachment Following Cataract Surgery at a Tertiary Center in Jeddah, Saudi Arabia. Cureus 2023; 15:e33968. [PMID: 36820125 PMCID: PMC9938717 DOI: 10.7759/cureus.33968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 01/20/2023] Open
Abstract
Introduction The incidence of retinal detachment in the general population is 0.08%, it has been reported to reach 0.7% or higher following cataract surgery. One of the most important risk factors for retinal detachment is posterior capsular rupture during cataract surgery. Additional risk factors include high myopia, history of ocular trauma, young age, male sex, and diabetes. In this study, we aimed to investigate the incidence and risk factors of retinal detachment following cataract surgery in patients treated at our hospital. Materials and methods This retrospective cohort study was conducted at King Abdulaziz University Hospital (KAUH), a tertiary center in Jeddah, Saudi Arabia. The medical records of 365 patients (365 eyes) who underwent cataract surgery from 2017 to 2021 were reviewed. Results The average age of the 365 patients was 63 years, and 47.7% (n=174) of patients were male. The incidence of retinal detachment was 3.3% (n=12). The risk of RD was 2.8 times higher for the right eye than for the left eye. The incidence of RD was significantly more in eyes with intraoperative posterior capsular rupture, zonular dehiscence, corneal trauma, and surgery combined with anterior vitrectomy than in other eyes. The most common complication of cataract surgery is corneal edema, which was observed in 22.7% of the eyes; our analysis revealed a significant relationship between corneal edema and the duration of surgery. Conclusion In our study, we highlighted the higher incidence of retinal detachment compared to those in other studies; most cases occurred one month postoperatively.
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Frederick GA, Bonilla-Escobar FJ, Acosta A, Candelo PC, Castro A. Associated factors with pseudophakic retinal detachment: Long-term follow-up in a Colombian population. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2022; 97:663-669. [PMID: 36097149 DOI: 10.1016/j.oftale.2022.09.001] [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: 03/22/2022] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To identify associated factors with the appearance of pseudophakic retinal detachment in patients with history of cataract surgery. METHODS Retrospective case-control study of 802 eyes of 783 patients with history of cataract surgery. Cases were patients with pseudophakic retinal detachment (n = 258 eyes), while controls were patients with cataract surgery who did not developed retinal detachment during a 10-year follow-up period (n = 544 eyes). RESULTS Age at cataract surgery among cases was lower than in the control group (57 ± 13 vs. 67 ± 14 years old, respectively; p < 0.0001). Age at retinal detachment was 59 ± 13 years old (range 6-88) and the time between the cataract surgery and the retinal detachment had a median of 2 years (interquartile range 1-4) with a range of 1 month to 14 years. Associated factors for pseudophakic retinal detachment were younger age (<50 years: adjusted odds ratio [aOR] = 18.03, 95% confidence interval [95%CI] = 5.92-54.87; 50-59 years: aOR = 10.09, 95%CI = 3.37-30.23; and 60-69 years: aOR = 5.48, 95%CI = 1.88-15.93), male sex (aOR = 3.71, 95%CI = 2.54-5.44), anterior vitrectomy (aOR = 3.26, 95%CI = 1.16-9.16), history of retinal detachment in the fellow eye (aOR = 6.95, 95%CI = 3.15-15.31), and intraoperative complications during cataract extraction (aOR = 7.45, 95%CI = 3.54-15.69). CONCLUSIONS This is the first report of associated factors with pseudophakic retinal detachment in a Colombian population. Surgical complications, sex, and age were found to be associated with retinal detachment. Patients should be aware of these potential risks to make informed decisions about their eye health.
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Affiliation(s)
- G A Frederick
- Retina y Vítreo, Clínica de Oftalmología de Cali, Cali, Colombia.
| | - F J Bonilla-Escobar
- Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO, Servicio de Oftalmología, Universidad del Valleorg, Cali, Colombia; Grupo de investigación en Visión y Salud Ocular, VISOC, Servicio de Oftalmología, Universidad del Valle, Cali, Colombia; Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - A Acosta
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - P C Candelo
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - A Castro
- Retina y Vítreo, Clínica de Oftalmología de Cali, Cali, Colombia
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Thylefors J, Jakobsson G, Zetterberg M, Sheikh R. Retinal detachment after cataract surgery: a population-based study. Acta Ophthalmol 2022; 100:e1595-e1599. [PMID: 35338568 PMCID: PMC9790371 DOI: 10.1111/aos.15142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE To analyse the risk of rhegmatogenous retinal detachment (RRD) after cataract surgery, and to identify possible risk factors. METHOD Observational cohort study of patients undergoing cataract surgery in Region Skåne, southern Sweden, during 2015-2017 were retrieved from the Swedish National Cataract Register. These were then cross-referenced with cases of retinal detachment surgery performed at the Skåne University Hospital in Lund from 2015 to 2020. The main outcome was RRD after cataract surgery. The influence of sex, age, axial length of the eye, rupture of the posterior capsule, patient comorbidity and other cataract complications were analysed. RESULTS Among the 58 624 cases of cataract surgery, a total of 298 RRDs (0.51%) were identified up to the end of 2020. The mean time from cataract surgery to RRD was 667 days. The mean age was 65.3 years, compared to 74 years in the control group. A strong correlation was found between RDD and age: <60 years, incidence = 0.50%; 60-75 years, incidence = 0.14%; and >75 years, incidence = 0.04%. The correlation with axial length was also very strong: mean value 23.73 mm in those without RRD, and 25.13 mm in those with RRD (p < 0.001). Sex was also strongly correlated to RDD; 68.8% of cases of RRD being men. Among men younger than 60 years of age, with an axial length ≥25 mm, 9.46% exhibited RRD within the follow-up period (mean 4.7 years). Rupture of the posterior capsule was found in 2.01% of RRD patients compared to 0.74% in the control group. Diabetes, glaucoma or pseudoexfoliation had no impact on the prevalence of RRD. CONCLUSIONS The three main risk factors for RRD following cataract surgery were found to be sex, age and axial length. The highest incidence of RRD (9.46%) were identified among men younger than 60 years of age and an axial length ≥25 mm.
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Affiliation(s)
- Joakim Thylefors
- Department of Clinical Sciences LundOphthalmologySkåne University HospitalLund UniversityLundSweden
| | - Gunnar Jakobsson
- Department of OphthalmologySahlgrenska University HospitalMölndalSweden
| | | | - Rafi Sheikh
- Department of Clinical Sciences LundOphthalmologySkåne University HospitalLund UniversityLundSweden
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Alonso-Juárez E, Velázquez-Villoria D. Low Diopter Phakic Implantable Collamer Lens: Refractive and Visual Outcomes in Low Myopia and Myopic Astigmatism. Clin Ophthalmol 2022; 16:2969-2977. [PMID: 36081600 PMCID: PMC9447455 DOI: 10.2147/opth.s373378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/23/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ernesto Alonso-Juárez
- INSADOF Clinic, Salamanca, Spain
- Correspondence: Ernesto Alonso-Juárez, INSADOF, Calle Doctrinos, 4, 1, Salamanca, 37002, Spain, Email
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Achour H, Thomseth VM, Kvaløy JT, Krohn J, Utheim TP, Forsaa VA. Substantial increase in the incidence of rhegmatogenous retinal detachment in Western Norway over 20 years. Acta Ophthalmol 2022; 100:763-768. [PMID: 35261167 DOI: 10.1111/aos.15119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/29/2022] [Accepted: 02/18/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Hamida Achour
- Institute of Clinical Medicine, Faculty of Medicine University of Oslo Oslo Norway
- Department of Ophthalmology Stavanger University Hospital Stavanger Norway
| | - Vilde Marie Thomseth
- Department of Ophthalmology Stavanger University Hospital Stavanger Norway
- Department of Quality and Health Technology University of Stavanger Stavanger Norway
| | - Jan Terje Kvaløy
- Department of Mathematics and Physics University of Stavanger Stavanger Norway
- Department of Research Stavanger University Hospital Stavanger Norway
| | - Jørgen Krohn
- Department of Clinical Medicine, Section of Ophthalmology University of Bergen Bergen Norway
- Department of Ophthalmology Haukeland University Hospital Bergen Norway
| | - Tor P. Utheim
- Department of Ophthalmology Stavanger University Hospital Stavanger Norway
- Department of Quality and Health Technology University of Stavanger Stavanger Norway
- Department of Clinical Medicine, Faculty of Medicine University of Bergen Bergen Norway
| | - Vegard Asgeir Forsaa
- Department of Ophthalmology Stavanger University Hospital Stavanger Norway
- Department of Quality and Health Technology University of Stavanger Stavanger Norway
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Elsaadani I, Khater A, Eleiwa T. Role of anterior chamber maintainer in preventing pseudophakic retinal detachment in highly myopic eyes. JOURNAL OF THE EGYPTIAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.4103/ejos.ejos_35_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Elbaz U, Hakkala L, Hecht I, Achiron A, Gershoni A, Tuuminen R. Nd:YAG capsulotomy is not a risk factor for retinal detachment after phacoemulsification cataract surgery. Acta Ophthalmol 2021; 99:e1018-e1026. [PMID: 33423371 DOI: 10.1111/aos.14757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE To evaluate the cumulative incidence and risk factors of pseudophakic retinal detachment (PRD) following phacoemulsification cataract surgery. METHODS Cataract surgeries performed between the years 2007 and 2016 at the Ophthalmology Unit of Kymenlaakso Central Hospital, Kotka, Finland, were included. The cumulative incidence of PRD was estimated through Kaplan-Meier analysis. Patient mortality was incorporated as one of the censoring events. Cox regression analyses were used to evaluate potential risk factors, including age, gender, intraocular lens (IOL) power and previous neodymium-doped yttrium aluminium garnet (Nd:YAG) laser capsulotomy. RESULTS A total of 17 688 eyes of 12 003 patients were included. The mean patient age at surgery was 75.2 ± 9.1 years with 63.5% females (n = 11 228). During the mean follow-up time of 4.3 ± 2.7 years, 83 laterality-matched PRDs were registered (incidence 0.11% per year). Univariate analyses showed that age (HR 0.93; 95% CI 0.92-0.95), male gender (HR 3.99; 95% CI 2.52-6.33) and IOL power (HR 0.86; 95% CI 0.83-0.90) were significantly associated with PRD (p < 0.001 for all) and remained significant in a multivariate analysis. Neither univariate (HR 1.45; 95% CI 0.82-2.54, p = 0.201) nor multivariate (HR 1.03; 95%CI 0.57-1.88, p = 0.919) analyses showed any association between Nd:YAG capsulotomy and PRD. CONCLUSIONS Male gender, low IOL power and younger age were confirmed as risk factors for PRD after phacoemulsification surgery. Real-world evidence suggests that Nd:YAG capsulotomy does not increase the risk for PRD.
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Affiliation(s)
- Uri Elbaz
- Department of Ophthalmology Rabin Medical Center Schneider Children's Medical Center of Israel Petah Tikva Israel
- Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Laura Hakkala
- Helsinki Retina Research Group University of Helsinki Helsinki Finland
| | - Idan Hecht
- Sackler School of Medicine Tel Aviv University Tel Aviv Israel
- Helsinki Retina Research Group University of Helsinki Helsinki Finland
- Department of Ophthalmology Shamir Medical Center Tel Aviv Israel
| | - Asaf Achiron
- Sackler School of Medicine Tel Aviv University Tel Aviv Israel
- Cornea Unit Bristol Eye Hospital Bristol UK
| | - Assaf Gershoni
- Department of Ophthalmology Rabin Medical Center Schneider Children's Medical Center of Israel Petah Tikva Israel
- Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Raimo Tuuminen
- Helsinki Retina Research Group University of Helsinki Helsinki Finland
- Department of Ophthalmology Kymenlaakso Central Hospital Kotka Finland
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Effect of Nd: YAG laser capsulotomy on the risk of retinal detachment after cataract surgery: A systematic review and meta-analysis. J Cataract Refract Surg 2021; 48:238-244. [PMID: 34538778 DOI: 10.1097/j.jcrs.0000000000000755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/20/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT We aimed to evaluate the impact of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy on the incidence of pseudophakic retinal detachment (RD). The PubMed and Embase databases were searched for meta-analysis. Subgroup analyses were conducted according to study location, number of cases, mean follow-up time, and cataract procedure. The final analysis included 11 studies with 309 cases of RD in 65,117 eyes undergoing cataract surgery. Among them, 8,232 eyes underwent Nd:YAG capsulotomy. Our analysis demonstrated an increased risk of RD with Nd:YAG laser capsulotomy (RR=1.57; 95%CI, 1.17-2.12; P=0.003; HR=1.64; 95%CI, 1.03-2.62; P=0.04). Subgroup analysis suggested somewhat stronger associations in Asian (RR=4.54; 95%CI, 2.20-9.38; P<0.0001) than in non-Asian populations (America, P=0.12; Europe and others, P=0.21), and with extracapsular cataract extraction (RR=2.97; 95%CI, 1.83-4.83; P<0.0001) than with phacoemulsification (P=0.95). To conclude, Nd:YAG laser capsulotomy may be associated with an increased risk of pseudophakic RD.
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Javaloy J, Druchkiv V, Beltrán J, Moya J, Albarrán-Diego C, Montalbán R, Muñoz G. Retinal detachment after phacoemulsification in refractive surgery clinics: a large series analysis with variable follow-up during 16 years. Graefes Arch Clin Exp Ophthalmol 2021; 259:1555-1567. [PMID: 33791845 DOI: 10.1007/s00417-021-05160-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 03/07/2021] [Accepted: 03/10/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To determine the long-term incidence of pseudophakic retinal detachment (PRD) after phacoemulsification and the weight of the main risk factors in the appearance of such complication in a large sample. To implement a customized formula and a software calculation program able to quantify the risk of suffering PRD applicable to all lens extraction patients. METHODS Retrospective cumulative risk analysis conducted on 178,515 eyes operated under similar conditions in a group of refractive surgery clinics (Clínica Baviera SL) located in a relatively limited geographical area (Spain). A survival analysis was performed and the data were modelled using the Weibull regression to determine the risk over a period of 16 years and to estimate the association of different risk factors: sex, age, axial length (AXL) of the eye, intraoperative posterior capsule rents (PCR), and YAG laser capsulotomies. The resulting estimates were translated into a predictive equation for hazard rates and survival probabilities. Later, an application was developed to make prediction available for the clinical community in order to estimate the potential risk of any hypothetical case before lens surgery. RESULTS Globally, 1521 (0.85%) cases of PRD were diagnosed during the period. The risk for PRD was significantly greater in males (5.48 [2.94-10.2]; p < 0.001), in long eyes (1.24 [1.21-1.26]; p < 0.001), and also after posterior capsule rents (13.97 [11.61-16.82]; p < 0.001). Posterior capsule rupture increased the risk of PRD up to fourteen times. CONCLUSIONS From weaker to stronger impact, age, axial length, sex, and intraoperative posterior capsule rent were significant risk factors for the appearance of PRD after lens extraction.
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Affiliation(s)
- Jaime Javaloy
- Department of Refractive Surgery, Clínica Baviera Alicante, Alicante, Spain.
| | - Vasyl Druchkiv
- Department of Research and Development, Clínica Baviera Valencia, Valencia, Spain
| | - Jaime Beltrán
- Department of Research and Development, Clínica Baviera Valencia, Valencia, Spain
| | - Jaime Moya
- Department of Ophthalmology, Hospital Virgen de los Lirios, Alcoy, Spain
| | | | - Raúl Montalbán
- Department of Refractive Surgery, Clínica Baviera Alicante, Alicante, Spain
| | - Gonzalo Muñoz
- Department of Refractive Surgery, Clínica Baviera Castellón, Castellón, Spain
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15
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Dervenis N, Praidou A, Dervenis P, Chiras D, Little B. Visual Acuity Outcomes after Phacoemulsification in Eyes with Good Visual Acuity before Cataract Surgery. Med Princ Pract 2021; 30:285-291. [PMID: 33494090 PMCID: PMC8280449 DOI: 10.1159/000514662] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 01/21/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE to analyse cataract surgery outcomes and related factors in eyes presenting with good visual acuity. SUBJECT AND METHODS A retrospective longitudinal study of patients undergoing phacoemulsification between 2014 and 2018 in Moorfields Eye Hospital was conducted. Pre- and post-operative visual acuities were analysed. Inclusion criteria were age ≥40 years and pinhole visual acuity ≥6/9 pre-operatively. Exclusion criteria were no post-operative visual acuity data. The visual acuity change variable was also defined according to post-operative visual acuity being above or below the Snellen 6/9 threshold. RESULTS 2,720 eyes were included. The unaided logMAR visual acuity improved from 0.54 to 0.20 (p < 0.001), the logMAR visual acuity with glasses improved from 0.35 to 0.05 (p < 0.001), and the logMAR pinhole visual acuity improved from 0.17 to 0.13 (p < 0.001); 8.1% of patients had Snellen visual acuity <6/9 post-operatively. Mean follow-up period was 23.6 ± 9.9 days. In multivariate analysis, factors associated with visual acuity <6/9 post-operatively were age (OR = 0.96, 95% confidence interval [CI] [0.95, 0.98], p < 0.001), vitreous loss (OR = 0.21, 95% CI [0.08, 0.56], p = 0.002), and iris trauma (OR = 0.28, 95% CI [0.10, 0.82] p = 0.02). CONCLUSIONS Visual acuity improved significantly, although at least 8.1% of them did not reach their pinhole preoperative visual acuity. Worse visual acuity outcomes were associated with increasing age, vitreous loss, and iris trauma. The 6/9 vision threshold may not be able to accurately differentiate those who may benefit from cataract surgery and those who may not.
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Affiliation(s)
- Nikolaos Dervenis
- Moorfields Eye Hospital, London, United Kingdom
- *Correspondence to: Nikolaos Dervenis,
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Packer M, Alfonso JF, Aramberri J, Elies D, Fernandez J, Mertens E. Performance and Safety of the Extended Depth of Focus Implantable Collamer ® Lens (EDOF ICL) in Phakic Subjects with Presbyopia. Clin Ophthalmol 2020; 14:2717-2730. [PMID: 32982164 PMCID: PMC7509320 DOI: 10.2147/opth.s271858] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/20/2020] [Indexed: 12/02/2022] Open
Abstract
Purpose To evaluate the performance and safety of the Extended Depth of Focus Implantable Collamer® Lens (EDOF ICL) for improvement of uncorrected near, intermediate and distance visual acuity in phakic subjects with myopia and presbyopia. Design Prospective multicenter study. Methods Presbyopic subjects who required an EDOF ICL in the range of −0.50 D to −18.00 D, exhibited ≤ 0.75 D refractive astigmatism and required from +1.00 to +2.50 D reading add were implanted bilaterally. Assessments at 6 months included uncorrected near, intermediate and distance visual acuities, defocus curves, contrast sensitivity, responses to the National Eye Institute Refractive Error Quality of Life Questionnaire and a Task Assessment Questionnaire. Results A total of 34 subjects completed the study. Investigators targeted emmetropia in all eyes. Mean binocular uncorrected near, intermediate and distance visual acuities measured logMAR −0.01 ± 0.05 (20/20), −0.02 ± 0.08 (20/19) and 0.07 ± 0.10 (20/23), respectively. Mean monocular uncorrected near, intermediate and distance visual acuities measured logMAR 0.068 ± 0.09 (20/23), 0.062 ± 0.10 (20/23) and 0.16 ± 0.12 (20/29). There were no clinically or statistically significant differences in contrast sensitivity between baseline and 6 months under any testing conditions. Subjects reported significant improvements in measures of vision-related quality of life and ability to perform tasks at all distances without glasses or contact lenses. Overall, satisfaction with the EDOF ICL was high: postoperatively, 91.2% of subjects were satisfied with their vision. Conclusion This multicenter, prospective clinical investigation demonstrated the ability of the EDOF ICL to correct myopia and presbyopia, resulting in improvement of uncorrected near, intermediate and distance visual acuity without compromising the quality of vision. The EDOF ICL allowed subjects to perform tasks of daily living without glasses or contact lenses. Subjects reported significant improvements in quality of life with high levels of spectacle independence and satisfaction.
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Affiliation(s)
- Mark Packer
- Packer Research Associates, Boulder, CO, USA
| | - Jose F Alfonso
- Ophthalmology Institute Fernández Vega, Oviedo, Asturias, Spain
| | | | - Daniel Elies
- Institute of Ocular Microsurgery, Barcelona, Spain
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Park JH, Yang H, Kwon H, Jeon S. Risk Factors for Onset or Progression of Posterior Vitreous Detachment at the Vitreomacular Interface after Cataract Surgery. Ophthalmol Retina 2020; 5:270-278. [PMID: 32688082 DOI: 10.1016/j.oret.2020.07.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/06/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To study the incidence and risk factors for onset or progression of posterior vitreous detachment (PVD) at the vitreomacular interface (VMI) after cataract surgery. DESIGN Retrospective case series. PARTICIPANTS Patients with a history of phacoemulsification from April 2018 through April 2019 at the Keye Eye Center, Seoul, Korea, and postoperative monitoring for more than 2 months. METHODS Cox proportional hazard ratios for the onset or development of PVD after cataract surgery in the presence of selected risk factors and demographic data were calculated. To evaluate the ocular risk factors, various ocular metrics, including spherical equivalent (SE), axial length (AL), anterior chamber depth, lens thickness, central subfield thickness, PVD status at macula and optic nerve head (ONH), peripapillary retinal nerve fiber layer thickness, and ONH parameters from OCT scans, were used for the analysis. MAIN OUTCOME MEASURES Onset or development of PVD at the VMI. RESULTS Among 988 eyes without PVD at baseline, 174 eyes (17.6%) showed changes in the VMI. Univariate analysis showed that age, SE, AL, PVD status at macula and ONH, and average and vertical cup-to-disc ratios (CDRs) were associated significantly with PVD onset or development (P = 0.046, P = 0.004, P = 0.040, P < 0.001, P < 0.001, P = 0.008, and P = 0.042, respectively). In a multivariate analysis, PVD status at the macula and ONH and smaller CDR were associated with PVD onset or progression after cataract surgery after adjustment for age, SE, and AL (P < 0.001, P < 0.001, and P = 0.005, respectively). CONCLUSIONS The risk of PVD onset or progression was dependent on PVD status and the CDR detected on OCT scans, not on age or AL, in a large patient cohort. Patients who show risk factors on OCT should be monitored carefully during the postoperative period.
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Incidence and risk factors for retinal detachment after cataract surgery in Korea: a nationwide population-based study from 2011 to 2015. Graefes Arch Clin Exp Ophthalmol 2019; 257:2193-2202. [DOI: 10.1007/s00417-019-04423-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/10/2019] [Accepted: 07/11/2019] [Indexed: 10/26/2022] Open
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Ghazza A, Bakhsh M, Hajji I, Moutaouaki A. [Treatment of retinal detachment of the pseudophak: vitrectomy without episcleral indentation versus ab externo surgery]. Pan Afr Med J 2019; 32:44. [PMID: 31143349 PMCID: PMC6522180 DOI: 10.11604/pamj.2019.32.44.15489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 07/11/2018] [Indexed: 11/17/2022] Open
Abstract
Several factors predispose to the occurrence of rhegmatogenous retinal detachment, including cataract surgery, myopia, and degenerative lesions of the peripheral retina as well as eye trauma. This study aims to compare the anatomical and functional outcome of the two surgical techniques (AB interno vs AB externo) in our Hospital. We conducted a descriptive, retrospective study in the Department of Ophthalmology at the University Hospital Mohamed VI in Marrakech, over a period of 3 years, ranging from January 2013 to December 2015. During the study period we compared two groups of people: the first group undergoing surgery by an external approach (cryoapplication of the dehiscences with episcleral indentation) while the second undergoing surgery by endo-ocular approach. Group A or AB externo group included 26 eyes (26 patients) while Group B or vitrectomy with internal tamponade group included 22 eyes (22 patients). In the AB externo group, the average age was 54.92 years against 51.64 years in the AB interno group, with a slight predominance of males in both groups. After the first surgery, retinal reapplication was obtained in both groups with no significant difference, (about 80.76% in Group A versus 81.82% of the second group). In both groups failure was caused advanced vitreoretinal proliferation (4 cases), de novo breaks (3 cases) and breaks which had not been detected on first examinations (2 cases). All these cases underwent reoperation by AB interno approach: patients of group A underwent complete vitrectomy with revision of the indentation +/- internal limiting membrane peeling with internal gas tamponade while patients of group B underwent complementary vitrectomy with dissection of proliferative vitreoretinopathy (PVR) and an internal tamponade with silicone oil. After a mean follow-up period of 12 months, there was no significant difference in visual acuity between the 2 groups, with more than one third of the patients who had regained visual acuity between 1/10 and 5/10 (about 34,61% in AB externo group and 36,36% in AB interno group). Given the technological advances in vitrectomy, the current trend is the endo-ocular surgery however ab-externo surgery is mainly used in the treatment of retinal detachment with visible breaks which can be easily treated with indentation without advanced vitreoretineal proliferation (PVR A-B).
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Affiliation(s)
- Ahmed Ghazza
- Service d'Ophtalmologie, CHU Mohamed VI, Marrakech, Maroc
| | - Maha Bakhsh
- Service d'Ophtalmologie, CHU Mohamed VI, Marrakech, Maroc
| | - Ibtissam Hajji
- Service d'Ophtalmologie, CHU Mohamed VI, Marrakech, Maroc
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Peak Occurrence of Retinal Detachment following Cataract Surgery: A Systematic Review and Pooled Analysis with Internal Validation. J Ophthalmol 2018; 2018:9206418. [PMID: 30595913 PMCID: PMC6282121 DOI: 10.1155/2018/9206418] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 10/18/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction Timing of retinal detachment (RD) following cataract surgery is of importance for both diagnostic and prognostic factors. However, results on RD onset-time following cataract surgery have been conflicting. Method A systematic pooled analysis of the literature regarding timing of retinal detachment following cataract surgery. Outcomes were verified against an independent dataset. Results Twenty-one studies, reporting on rates of RD in 3,352,094 eyes of 2,458,561 patients, met our inclusion criteria and were included in the analysis. The mean pooled time to RD following surgery was 23.12 months (95% CI: 17.79-28.45 months) with high heterogeneity between studies (I 2=100%, P < 0.00001). Meta-analytic pooling for the risk of retinal detachment revealed a risk of 1.167% (95% CI: 0.900 to 1.468, I 2=99.50%, P < 0.0001). A retrospective chart review identified 54 pseudophakic RD cases (mean age 65.5, 59.3% males). The 95% confidence interval for the mean time to RD was 3.1-6.75 years. Conclusions The interval between cataract surgery and RD in a pooled analysis revealed a mean time of approximately 1.5-2.3 years. However, there was high variability between studies. Validation based on our local results showed similar yet slightly longer time frames. Timing of pseudophakic retinal detachment might direct appropriate follow-up, assisting in earlier detection.
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