Frequency and predictors of retinal detachment after pediatric cataract surgery without primary intraocular lens implantation.

Abstract

PURPOSE:

To determine the frequency and to identify predictors of retinal detachment after pediatric cataract surgery without primary intraocular lens implantation.

METHODS:

Retrospective review at an eye hospital identified 1017 eyes among 579 patients who underwent limbal-approach surgery without primary IOL implantation at age < or =16 years for cataract unassociated with other ocular abnormalities aside from microcornea. Patients had a minimum of 2 years postoperative follow-up. The outcome measure was the presence or absence of postcataract surgery retinal detachment, and analyses were performed on patients' eyes with adjustment for intrasubject correlation.

RESULTS:

Mean postcataract surgery follow-up was 6.8 +/- 3.6 years (range, 2.0 to 18.3 years). Retinal detachment developed in 33 (3.2%) of the 1017 patients' eyes and was diagnosed at a mean of 6.8 +/- 4.4 years postcataract surgery (range, 0.4 to 14.8 years). Multivariable Cox proportional hazards regression analysis with adjustment for intrasubject correlation identified an aphakic refractive error more myopic than the age-adjusted aphakic norm [hazard ratio (HR), 5.9; 95% confidence interval (CI), 1.9 to 18.0; P = 0.002] and postcataract surgery wound dehiscence (HR, 15.4; 95% CI, 2.2 to 108.5; P = 0.006) as predictors of retinal detachment; a primary posterior capsulotomy/anterior vitrectomy procedure was not predictive of retinal detachment.

CONCLUSIONS:

Retinal detachment is infrequent following pediatric cataract surgery without primary IOL implantation, at least with short-term follow-up. A postoperative aphakic refractive error more myopic (less hyperopic) than the age-adjusted aphakic norm is predictive of this complication.

• Authors: Peter K Rabiah, Hongyan Du, Elizabeth A Hahn
• Journal: Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus (J AAPOS) Vol. 9 Issue 2 Pg. 152-9 (Apr 2005) ISSN: 1091-8531 [Print] United States
• PMID: 15838443 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aphakia, Postcataract (complications)
• Cataract Extraction (adverse effects)
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Incidence
• Infant
• Lens Implantation, Intraocular (adverse effects)
• Lenses, Intraocular
• Male
• Prognosis
• Proportional Hazards Models
• Retinal Detachment (diagnosis, epidemiology, etiology)
• Retrospective Studies
• Risk Factors
• Saudi Arabia (epidemiology)