The risk of a new retinal break or detachment following cataract surgery in eyes that had undergone repair of phakic break or detachment: a hypothesis of a causal relationship to cataract surgery.

PURPOSE To determine the risk of new retinal tear or detachment following cataract surgery in eyes that had undergone successful repair of phakic retinal tear or detachment. METHODS A computerized search of records of patients evaluated at the Barnes Retina Institute from 1990 to 2000 for a diagnosis of phakic retinal tear or detachment was accomplished. The records of successfully treated patients were analyzed by type of tear or detachment, method of treatment, and development of sequential new tears or detachment. Eyes that subsequently underwent cataract surgery were classified by presence and location of intraocular lens as well as operative complications, including capsular rupture, vitreous loss, or retained lens fragments. The frequency of developing new tears or detachment was calculated. RESULTS The 2,175 eyes identified were subdivided according to those that had undergone repair of retinal break (n = 1,415), subclinical retinal detachment (n = 396), or retinal detachment (n = 364). Of 371 eyes that underwent subsequent cataract surgery, 17 (4.6%) developed a new tear or detachment postoperatively. Factors indicative of higher postoperative risks included myopia, tear or detachment in the fellow eye, sequential onset of new breaks prior to cataract surgery, and complications of cataract surgery. CONCLUSION In patients who had undergone prior repair of retinal breaks or detachment, cataract surgery was associated with a 4.6% incidence of new breaks or detachment. Cataract surgery appears to be an independent risk factor for retinal tears or detachments. Dilated retinal examination following cataract surgery is advisable in patients who have previously undergone repair of a phakic retinal tear or detachment.