INCIDENCE OF RETINAL-DETACHMENT AFTER CATARACT-SURGERY AND NEODYMIUM-YAG LASER CAPSULOTOMY

The objective of this retrospective study was to determine the inciden ce of retinal detachment (RD) in patients following cataract extractio n with intraocular lens placement and after neodymium:YAG (Nd:YAG) las er capsulotomy. This study comprised 1092 patients (1168 eyes) who had cataract extraction and related procedures between January 1986 and D ecember 1992 identified from the coding and billing database. Of the 1 092 patients, 215 (244 eyes) had had Nd:YAG laser capsulotomy. Their c harts were reviewed for incidence of RD, and these data were correlate d with age, sex, axial length, surgical complications, and other surgi cal procedures done at the time of cataract extraction. The incidence of RD following phacoemulsification alone was 0.75% (6/799), with a me an time between cataract extraction and RD of 11.6 months. The cases o f RD after extracapsular cataract extraction, combined phacoemulsifica tion and trabeculectomy, combined extracapsular cataract extraction an d penetrating keratoplasty, and combined phacoemulsification and anter ior vitrectomy were too few to draw any conclusions. The incidence of RD following Nd:YAG laser capsulotomy was 0.82% (2/244), with a mean t ime of 32 months between cataract surgery and capsulotomy and 13.5 mon ths between capsulotomy and RD. There was a statistically significant higher incidence of RD after posterior capsule rupture and anterior vi trectomy than after uncomplicated phacoemulsification (2/12 versus 6/7 99). In conclusion, the rate of RD after uncomplicated phacoemulsifica tion was less than or similar to the rate found in other recent studie s. It was not statistically different from the rate following phacoemu lsification and Nd:YAG laser capsulotomy (0.82%). This study confirms the increased risk of RD following posterior capsule rupture and anter ior vitrectomy.