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Cataract surgery not a risk factor for retinal detachment in highly myopic eyes, study says
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BERLIN — Cataract surgery is not a demonstrated risk factor for retinal detachment in highly myopic eyes, and the risk profile for postoperative retinal detachment is the same as the risk profile for idiopathic retinal detachment, according to a study on a large cohort of patients.
"We performed a retrospective analysis of 1,519 consecutive patients (2,356 eyes) with an axial length greater than 27 mm who had planned phacoemulsification. Postoperative incidence of retinal detachment was approximately 2%, with a follow-up of 2 years in 84% of the cases," Irmingard Neuhann, MD, said at the World Ophthalmology Congress here.
This relatively high incidence confirms the results of the majority of the studies published in literature. However, no large epidemiological study has ever demonstrated that this rate is different from that of spontaneous retinal detachment in myopes with comparable axial length, she said.
"In our study, we found that the rate of idiopathic retinal detachment, occurred before surgery, was equally high. Consequently, it is difficult to demonstrate whether cataract surgery is actually a risk factor for [retinal detachment] in high myopes," Dr. Neuhann said.
Retinal detachment is a predisposition that comes with myopia.
"To my patients, I tell that the risk of having retinal detachment following cataract surgery is not greater than the risk that they would have anyhow. There is no evidence or scientifically plausible mechanism that should make cataract surgery an additional risk factor for retinal detachment," she said.
This study reports an incidence of retinal detachment of 2% after a 2-year follow-up of cataract surgery in highly myopic eyes, which would be similar to the rate of spontaneous retinal detachment in myopes with comparable axial length. This report is very informative, but maybe slightly optimistic.
There is a consensus that the risk of retinal detachment has decreased with the development of safer lensectomy techniques that avoid anterior chamber fluctuations, and improvement of IOL design has also decreased the incidence of posterior capsule opacification.
However, we must remain very cautious when performing clear lensectomy in highly myopic eyes, done on much younger patients with specific vitreoretinal lesions.
– Joseph Colin, MD
OSN Europe Edition
Chairman of the Editorial Board
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