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Risk factors for retinal detachment following cataract surgery: the impact of posterior capsular rupture
  1. Vasileios Petousis1,
  2. Ahmed A Sallam1,
  3. Richard J Haynes2,
  4. C K Patel3,
  5. Ajai K Tyagi4,
  6. James N Kirkpatrick1,
  7. Robert L Johnston1
  1. 1Department of Ophthalmology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
  2. 2Vitreoretinal Unit, Bristol Eye Hospital, Bristol, UK
  3. 3Department of Ophthalmology, Oxford Radcliffe Hospitals NHS Foundation Trust, Oxford, UK
  4. 4Department of Ophthalmology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
  1. Correspondence to Robert L Johnston, Department of Ophthalmology, Cheltenham General Hospital, Sandford Road, Cheltenham, Gloucestershire GL53 7AN, UK; rob.johnston{at}


Aim To investigate risk factors for retinal detachment (RD) after cataract surgery, particularly posterior capsular rupture (PCR) with or without vitreous loss.

Methods Single centre electronic medical record database study of 18 065 consecutive first eye cataract operations performed between 2005 and 2014. Survival analysis was performed with Kaplan–Meier curves and a Cox proportional hazard regression analysis to calculate HRs with respect to RD.

Results The RD rate at 3 months and 7 years was 0.067% and 0.30%, respectively, with a median time to RD of 15 months (mean: 18 months, range: 0–84 months). Men had a higher RD risk (HR 2.00; 95% CI 1.03 to 3.88; p=0.03) in the univariate model. Patients <60 years and those >80 years had an HR of 5.12 (95% CI 2.60 to 10.07; p<0.001) and 0.16 (95% CI 0.38 to 0.69; p=0.01), respectively, compared with patients 60–80 years of age. Eyes longer than 25 mm had an HR of 3.98 (95% CI 1.93 to 8.20; p<0.001) compared with eyes 23–25 mm. PCR occurred in 400 (2.2%) eyes. The HR for RD was 12.83 (95% CI 5.62 to 29.30; p<0.001) for PCR with vitreous loss. There were no RD events in eyes with PCR without vitreous loss.

Conclusions The risk for RD after cataract surgery is higher in younger patients and eyes with longer axial length or PCR with vitreous loss during surgery.

  • Treatment Surgery
  • Vitreous
  • Retina
  • Lens and zonules

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  • Contributors All authors had a substantial contribution to the conception, the design of the work, the acquisition and the analysis or interpretation of data. They all helped with drafting the work or revising it critically for important intellectual content. They all approved the final version sent to the journal for publishing and they agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests RLJ is a director and shareholder in Medisoft the electronic medical record (EMR) supplier that has its EMR installed at the hospitals from which data were extracted.

  • Ethics approval This is a retrospective data analysis study and was approved by clinical audit review board of the Gloucestershire Hospitals NHS Foundation Trust.

  • Provenance and peer review Not commissioned; externally peer reviewed.