Incidence, risk factors and impact of age on retinal detachment following cataract surgery in France: a national population study
Résumé
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.
Domaines
Organes des sens
Origine : Fichiers produits par l'(les) auteur(s)
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