Retinal Redetachment after Cataract Surgery in Eyes with Previous Scleral Buckling

Removal of the crystalline lens is associated with a substantial increase in the rate of retinal tears and detachments. Retinal detachment (RD) occurs in 2 to 3% of eyes following intracapsular cataract extraction (ICCE), 0.5 to 2 % of eyes following extracapsular cataract extraction (ECCE) but is believed to occur in a smaller percentage of eyes following phacoemulsification. RD frequently occurs within 6 months of cataract surgery or following posterior capsulotomy. 1,2 Predisposing factors for RD after cataract surgery include axial myopia, lattice retinal degeneration, previous RD or retinal tear in the operated eye, history of RD in the fellow eye, and family history of RD. An intact posterior capsule appears to be associated with a reduced rate of RD following cataract surgery. When an ophthalmologist confronts a patient with a history of previous RD requiring cataract surgery, the first question is: how much is the risk of retinal redetachment after cataract surgery? We designed a prospective interventional case series to evaluate the rate of retinal detachment after cataract surgery in patients with previous rhegmatogenous RD who had been successfully treated by scleral buckling surgery. This study included patients who were referred to the Retina Clinic at Poostchi and Motahari Eye Hospitals between March 2006 and October 2009. These patients had previous rhegmatogenous RD and were treated successfully by various techniques of scleral buckling 1 to 10 years before. Patients who had vitrectomy, pneumatic retinopexy, or multiple operations for RD or techniques other than scleral buckling and those who had developed non-rhegmatogenous RD were excluded from the study. All patients underwent cataract surgery (phacoemulsification or extracapsular surgery with or without an intraocular lens) and were followed for at least one year. The rate of retinal redetachment was evaluated for patients who had completed at least one year of follow up. For patients who had developed posterior capsular opacity during follow up, Nd:YAG laser capsulotomy was performed at least 6 months after cataract surgery. All patients who required laser capsulotomy, were followed for at least one year after the procedure and the rate of retinal redetachment was evaluated. A total of 21 patients (10 male and 11 female subjects) with mean age of 65.3±7.6 years were included in the study and followed for 1.88±0.49 (range, 1 to 2.5) years. Scleral buckling had been performed from 1 year to more than 10 years prior to cataract surgery at a mean interval of …