Cataract Progression after Surgical Intervention for Uncomplicated Rhegmatogenous Retinal Detachments in Young Adults

Document Type

Conference Proceeding

Publication Date

6-1-2023

Publication Title

Invest Ophthalmol Vis Sci

Abstract

Purpose : To determine the rates and risk factors for cataract progression after surgical intervention for uncomplicated rhegmatogenous retinal detachment (RRD) in young eyes. Methods : Retrospective cohort study of patients between the ages of 15 to 45 without prior retinal surgery undergoing pars plana vitrectomy (PPV), scleral buckling (SB), or combined PPV+SB for uncomplicated RRD between 2014 and 2020. Exclusion criteria included pseudophakic or aphakic eyes, eyes requiring multiple surgeries for RRD repair, eyes without at least 3 months of follow-up, eyes requiring lensectomy at the time of initial RRD repair, and combined detachments. Results : Thirty-six eyes from 34 patients met inclusion criteria with 28, 5, and 3 eyes undergoing PPV, PPV+SB, SB, respectively. The mean age at initial surgery was 35, 30, and 27 years with an average follow-up length of 859, 446, 452 days in PPV, PPV+SB, and SB eyes, respectively. Cataracts developed in 20/28, 5/5, and 1/3 eyes after PPV, PPV+SB, and SB, respectively with 17/20, 5/5, and 1/1 developing within 1 year. Cataract extraction was performed in 11/20, 1/5, and 0/1 PPV, PPV+SB, and SB eyes, respectively. After PPV, posterior subcapsular cataract rates were higher in patients below 35 (6/11 eyes) compared to above 35 years (7/17 eyes)(p=0.329) and nuclear sclerotic cataract (NSC) rates were higher in patients above 35 (11/17 eyes) compared to below 35 years (2/11 eyes) (p=0.022). Cataracts developed more frequently after macula-off RRD (14/16 eyes) compared to macula-on RRDs (6/12 eyes) (p=0.044) with NSC being more common in macula-off detachments (p=0.02). No other significant association between age, refractive status, vitreous status, and surgical time and cataract rate was observed. Conclusions : Cataract formation was common and frequent after PPV and PPV+SB but rare after SB in young patients undergoing RRD repair. Majority of cataracts after RRD repair develop within 1 year. PPV eyes were more likely to require cataract extraction compared to other repair methods. As majority of the studies analyzing cataract formation after retinal surgeries in young eyes are limited by small cohorts, further prospective studies or big-data retrospective studies should be performed to better assess the risk of cataract formation in these eyes.

Volume

64

Issue

8

First Page

OD84

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