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    Risk for Retinal Detachment After Phacoemulsification: A Whole-Population Study of Cataract Surgery Outcomes

    187107_187107.pdf (158.8Kb)
    Access Status
    Open access
    Authors
    Clark, Antony
    Morlet, Nigel
    Ng, Jonathon
    Preen, D.
    Semmens, James
    Date
    2012
    Type
    Journal Article
    
    Metadata
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    Citation
    Clark, Antony and Morlet, Nigel and Ng, Jonathon Q. and Preen, David B. and Semmens, James B. 2012. Risk for Retinal Detachment After Phacoemulsification: A Whole-Population Study of Cataract Surgery Outcomes. Archives of Ophthalmology. 130 (7): pp. 882-888.
    Source Title
    Archives of Ophthalmology
    DOI
    10.1001/archophthalmol.2012.164
    ISSN
    00039950
    URI
    http://hdl.handle.net/20.500.11937/22716
    Collection
    • Curtin Research Publications
    Abstract

    Objectives: To estimate the long-term cumulative incidence of and risk factors for retinal detachment (RD) after phacoemulsification using linked administrative medical data. Methods: We used the Western Australian Data Linkage System to identify patients who underwent phacoemulsification in Western Australia between January 1989 and December 2001. Retinal detachment cases were those patients requiring admission for RD surgery after phacoemulsification that were validated by medical record review. Kaplan-Meier analysis was used to calculate a cumulative incidence. Cox proportional hazards regression modeling was used to determine the association between RD and risk factors, including patient demographics and operative and hospital factors. Some important risk factors, including axial length and Nd:YAG laser capsulotomy, were not examined. Results: We identified 237 RD cases following 65 055 phacoemulsification procedures, with a 10-year cumulative incidence of 0.68% (95% CI, 0.56%-0.83%). Significant risk factors were year of surgery (hazard ratio [HR], 0.43; 95% CI, 0.28-0.66 [1999-2001 compared with 1989-1993] for each 5-year period after 1985), age younger than 60 years (3.76; 2.83-5.00), male sex (1.91; 1.45-2.51), and anterior vitrectomy (27.60; 19.27-39.52). Hospital location, patient rural or remote locality, hospital cataract surgery volume, failed intraocular lens insertion, length of stay, and patient insurance status were not significantly associated with RD. Conclusions: Risk for RD after phacoemulsification has almost halved for each 5-year period since its adoption in the mid 1980s. Younger patient age and male sex at surgery significantly increased risk for RD. Phacoemulsification requiring anterior vitrectomy vastly increased risk for RD.

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