Incidence, Risk Factors, and Impact of Age on Retinal Detachment after Cataract Surgery in France: A National Population Study

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• 作者：Vincent Daien ; MD ; PhD¹ ; ² ; ³ ; ^{vincent.daien@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Annick Le Pape ; MS⁴ ; Didier Heve ; MD⁴ ; Isabelle Carriere ; PhD¹ ; Max Villain ; MD ; PhD² ; ³
• 关键词：CI ; confidence interval ; HR ; hazard ratio ; PMSI ; Programme de Mé ; dicalisation des Systè ; mes d'information ; RD ; retinal detachment
• 刊名：Ophthalmology
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：122
• 期：11
• 页码：2179-2185
• 全文大小：608 K

文摘

To assess the incidence, risk factors, and impact of age on retinal detachment (RD) after cataract surgery.

Design

Cohort study.

Participants

All patients older than 40 years of age 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, 2680167 eyes in 1787021 patients (59.4% women; mean age, 73.9±9.5 years) underwent cataract surgery. A total of 11 424 patients experienced 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 [CI], 3.79–3.95) for cataract surgery itself. The multiadjusted hazard ratio (HR) associated with increased risk of RD was 5.22 (95% CI, 5.05–5.39) for patients 40 to 54 years of age, 3.69 (95% CI, 3.60–3.79) for those 55 to 64 years of age, and 1.98 (95% CI, 1.93–2.03) for those 65 to 74 years of age as compared with those 75 years of age or older. Retinal detachment was associated with high myopia (HR, 6.12; 95% CI, 5.84–6.41), vitrectomy for perioperative capsular rupture (HR, 4.36; 95% CI, 4.07–4.68), history of eye trauma (HR, 3.98; 95% CI, 3.69–4.30), extracapsular extraction (HR, 3.11; 95% CI, 2.94–3.30), male gender (HR, 2.39; 95% CI, 2.35–2.44), and history of diabetes (HR, 1.18; 95% CI, 1.15–1.21). In myopic patients, the multiadjusted HR associated with increased risk of RD was 25.02 (95% CI, 24.76–25.18) for patients 40 to 54 years of age, 20.37 (95% CI, 20.21–20.53) for those 55 to 64 years of age, and 17.05 (95% CI, 16.85–17.25) for those 65 to 74 years of age as compared with nonmyopic patients 75 years of age or older.

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.