Morano Michael J, Khan M Ali, Zhang Qiang, Halfpenny Colleen P, Wisner Douglas M, Sharpe James, Li Alexander, Tomaiuolo Maurizio, Haller Julia A, Hyman Leslie, Ho Allen C
Sidney Kimmel Medical College, Philadelphia, Pennsylvania.
Wills Eye Hospital, Philadelphia, Pennsylvania.
Ophthalmol Sci. 2023 Apr 18;3(4):100314. doi: 10.1016/j.xops.2023.100314. eCollection 2023 Dec.
To report the incidence of and evaluate demographic, ocular comorbidities, and intraoperative factors for rhegmatogenous retinal detachment (RRD) and retinal tear (RT) after cataract surgery in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight).
Retrospective cohort study.
Patients aged ≥ 40 years who underwent cataract surgery between 2014 and 2017.
Multivariable logistic regression was used to evaluate demographic, comorbidity, and intraoperative factors associated with RRD and RT after cataract surgery.
Incidence and risk factors for RRD or RT within 1 year of cataract surgery.
Of the 3 177 195 eyes of 1 983 712 patients included, 6690 (0.21%) developed RRD and 5489 (0.17%) developed RT without RRD within 1 year after cataract surgery. Multivariable logistic regression odds ratios (ORs) showed increased risk of RRD and RT, respectively, among men (OR 3.15; 95% confidence interval [CI], 2.99-3.32; < 0.001 and 1.79; 95% CI, 1.70-1.89; < 0.001), and younger ages compared with patients aged > 70, peaking at age 40 to 50 for RRD (8.61; 95% CI, 7.74-9.58; < 0.001) and age 50 to 60 for RT (2.74; 95% CI, 2.52-2.98; < 0.001). Increased odds of RRD were observed for procedure eyes with lattice degeneration (LD) (10.53; 95% CI, 9.82-11.28; < 0.001), hypermature cataract (1.61; 95% CI, 1.06-2.45; = 0.03), complex cataract surgery (1.52; 95% CI, 1.4-1.66; < 0.001), posterior vitreous detachment (PVD) (1.24; 95% CI, 1.15-1.34; < 0.001), and high myopia (1.2; 95% CI, 1.14-1.27; < 0.001). Lattice degeneration conferred the highest odds of RT (43.86; 95% CI, 41.39-46.49; < 0.001).
In the IRIS Registry, RRD occurs in approximately 1 in 500 cataract surgeries in patients aged > 40 years within 1 year of surgery. The presence of LD conferred the highest odds for RRD and RT after surgery. Additional risk factors for RRD included male gender, younger age, hypermature cataract, PVD, and high myopia. These data may be useful during the informed consent process for cataract surgery and help identify patients at a higher risk of retinal complications.
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
在美国眼科学会IRIS®注册中心（智能视力研究）报告白内障手术后孔源性视网膜脱离（RRD）和视网膜裂孔（RT）的发生率，并评估其人口统计学、眼部合并症及术中因素。
回顾性队列研究。
2014年至2017年间接受白内障手术的年龄≥40岁的患者。
采用多变量逻辑回归分析评估白内障手术后与RRD和RT相关的人口统计学、合并症及术中因素。
白内障手术后1年内RRD或RT的发生率及危险因素。
纳入的1983712例患者的3177195只眼中，6690只（0.21%）在白内障手术后1年内发生RRD，5489只（0.17%）发生无RRD的RT。多变量逻辑回归优势比（OR）显示，男性发生RRD和RT的风险分别增加（OR 3.15；95%置信区间[CI]，2.99 - 3.32；P < 0.001和1.79；95% CI，1.70 - 1.89；P < 0.001），与年龄>70岁的患者相比，年龄较小者风险增加，RRD在40至50岁达到峰值（8.61；95% CI，7.74 - 9.58；P < 0.001），RT在50至60岁达到峰值（2.74；95% CI，2.52 - 2.98；P < 0.001）。有格子样变性（LD）的手术眼发生RRD的几率增加（10.53；95% CI，9.82 - 11.28；P < 0.001），过熟期白内障（1.61；95% CI，1.06 - 2.45；P = 0.03）、复杂白内障手术（1.52；95% CI，1.4 - 1.66；P < 0.001）、玻璃体后脱离（PVD）（1.24；95% CI，1.15 - 1.34；P < 0.001）和高度近视（1.2；95% CI，1.14 - 1.27；P < 0.001）也增加RRD几率。格子样变性导致RT的几率最高（43.86；95% CI，41.39 - 46.49；P < 0.001）。
在IRIS注册中心，年龄>40岁的患者中，白内障手术后1年内RRD的发生率约为每500例手术中有1例。LD的存在使手术后RRD和RT的几率最高。RRD的其他危险因素包括男性、年龄较小、过熟期白内障、PVD和高度近视。这些数据在白内障手术的知情同意过程中可能有用，并有助于识别视网膜并发症风险较高的患者。
作者对本文讨论的任何材料均无专有或商业利益。
