RD risk factors in RLE should be ‘clearly identifiable,’ surgeon says

CHICAGO — A comprehensive literature review found a higher rate of retinal detachment in patients who have undergone refractive lens exchange or cataract surgery than in the general population.

Emanuel Rosen, FRCOphth, who performed the review, said patients who have previously undergone refractive lens exchange present with cataract almost 10 years earlier than people in the general population.

“There are about 12 cases of retinal detachment per 100,000 people in the general population,” he said during Refractive Subspecialty Day at the American Academy of Ophthalmology meeting. Comparatively, the rate is 1.17% after phacoemulsification and 2% after refractive lens exchange, he said.

Mr. Rosen analyzed outcomes from 21 published papers; in a total of 6,522 eyes studied, 117 eyes with myopia suffered a retinal detachment. Mr. Rosen said the risk “increases to 1 in 12 if there was a capsular tear.”

Pseudophakia in myopic eyes “carries a higher risk of retinal detachment than in formerly emmetropic or hyperopic eyes, consequent upon the intrinsic vitreoretinal pathology associated with longer eye globe axial length and the consequent stretching or degeneration of both the vitreous and the retina,” he said.

Surgeons should discuss fully with potential refractive lens exchange candidates the risk factors, Mr. Rosen said. He said long-term case-control studies are warranted to help physicians further identify and quantify risk factors.