Relationship between retinal detachment and biometry in 4262 cataractous eyes.

PURPOSE: To assess risk factors for retinal detachment (RD) in eyes that previously underwent cataract surgery.

DESIGN: Retrospective cohort study.

PARTICIPANTS: Four thousand two hundred sixty-four eyes of 3094 patients who underwent extracapsular cataract extraction with intraocular lens (IOL) implantation at the Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam.

METHODS: From January 1, 1993, through March 31, 1999, 3094 patients (4262 cases) of extracapsular cataract extraction with IOL implantation were enrolled. Through review of ophthalmic patient records, the role of preoperative and intraoperative data as well as neodymium:yttrium-aluminum-garnet (Nd:YAG) capsulotomy was assessed with respect to development of an RD.

MAIN OUTCOME MEASURES: Axial length (AL), anterior chamber depth (ACD), crystalline lens thickness, mean keratometric power, spherical equivalent, intraoperative complications, Nd:YAG laser posterior capsulotomy, RD.

RESULTS: Of 4262 eyes that underwent cataract extraction, 3921 eyes (2794 patients) were available for analysis. Twenty-two patients experienced RD after surgery, resulting in an overall cumulative incidence of 0.62%. Multivariate binary logistic regression analyses showed the following factors to be associated with an increased risk of RD after cataract surgery: an accidental posterior capsular rupture at the time of surgery (odds ratio [OR] = 16.26; P<0.001), an increased AL (OR = 1.25; P = 0.013), and a deeper anterior chamber (OR = 4.02; P = 0.016). Older age was found to be a protective factor for the development of RD (OR = 0.95; P = 0.003).

CONCLUSIONS: Cataract surgery at a young age with an accidental posterior capsular rupture and a deeper ACD are the most important predisposing conditions for pseudophakic RD after cataract surgery. The overall cumulative incidence of 0.62% for postoperative RD is low.