Risk factors for retinal detachment after cataract surgery in southern Taiwan.

BACKGROUND This study was designed to investigate potential risk factors for retinal detachment (RD) after cataract surgery in southern Taiwan. METHODS This was a prospective cohort study. Submitted charts and claimed records for insurance beneficiaries who underwent cataract extraction between August 1999 and December 2001 were collected from the Bureau of National Health Insurance. Data from these records were examined, including demographic characteristics, past history, refractive status, axial length, and type and complications of cataract extraction. At the end of 2002, any ophthalmologic diagnosis and related treatments, based on procedure and diagnosis codes listed in physician bills, were evaluated. RESULTS A total of 9,398 patients were evaluated. The cumulative risk of RD in our study group was 0.4% at the end of follow-up. The mean follow-up time was 25.5 +/- 7.7 months. Age had a significant influence on the risk of RD after cataract surgery (p = 0.006), whereas gender did not. Axial length also had a significant effect on the risk of RD after cataract extraction (p < 0.001), whereas systemic disease or the type of operation did not correlate significantly with RD. Intraoperative complications had a significant influence on RD risk only in patients aged more than 60 years (p = 0.042). Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy significantly reduced the risk of RD only in patients aged 50 years or younger (p < 0.001). CONCLUSION Our results show that young age and long axial length are both significantly associated with RD after cataract surgery. A more restrictive attitude towards early cataract extraction may therefore be appropriate, especially in highly myopic patients.