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Incidence, risk factors and impact of age on retinal detachment following cataract surgery in France: a national population study

Abstract : Objective: To assess the incidence, risk factors and impact of age on retinal detachment (RD) following cataract surgery. Design: Cohort study Subjects: All patients > 40 years old who underwent a primary cataract surgery in France between January 2009 and December 2012. Methods: A Cox proportional-hazard regression model was used to analyze risk factors of RD after cataract surgery. Main Outcome Measures: Risk factors of RD after cataract surgery Results: Over 4 years, 2,680,167 eyes in 1,787,021 patients (59.4% women, mean age 73.9 ±9.5 years) underwent cataract surgery. A total of 11,424 patients had RD after cataract surgery, with an estimated risk of 0.99% at 4 years after surgery. The odds ratio associated with increased risk of RD was 3.87 (95% confidence interval [95% CI] 3.79 to 3.95) for cataract surgery itself. The multi-adjusted hazard ratio (HR) associated with increased risk of RD was 5.22 (95% CI 5.05 to 5.39) for patients 40-54 years, 3.69 (95% CI 3.60 to 3.79) for those 55-64 years and 1.98 (95% CI 1.93 to 2.03) for those 65 to 74 as compared with those ≥ 75 years old. RD was associated with high myopia (HR 6.12; 95% CI 5.84 to 6.41), vitrectomy for peri-operative capsular rupture (HR 4.36; 95% CI 4.07 to 4.68), history of eye trauma (HR 3.98; 95% CI 3.69 to 4.30), extracapsular extraction (HR 3.11; 95% CI 2.94 to 3.30), male gender (HR 2.39; 95% CI 2.35 to 2.44) and history of diabetes (HR 1.18; 95% CI 1.15 to 1.21). In myopic patients, the multi-adjusted HR associated with increased risk of RD was 25.02 (95% CI 24.76 to 25.18) for patients 40-54 years old, 20.37 (95% CI 20.21 to 20.53) for those 55-64 years old and 17.05 (95% CI 16.85 to 17.25) for those 65 to 74 years old as compared with non-myopic patients ≥ 75 years old. Conclusions: We provide a hierarchy of risk factors for RD onset: high myopia, young age, capsular rupture, history of eye trauma, extracapsular extraction technique, male gender and diabetes. Young age was an additional risk factor in myopic patients.
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Vincent Daien, Annick Le Pape, Didier Hève, Isabelle Carriere, Max Villain. Incidence, risk factors and impact of age on retinal detachment following cataract surgery in France: a national population study. Ophthalmology: Journal of The American Academy of Ophthalmology, Elsevier, 2015, pp.1. ⟨10.1016/j.ophtha.2015.07.014⟩. ⟨inserm-01193045⟩

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