Cataract surgery and the risk of retinal detachment

Is there a connection between cataract surgery and increased risk of retinal detachment?

According to studies, the answer is yes, particularly if you’re very nearsighted, and the risk can persist even years after the cataract surgery.

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In a comment published in a professional journal in 2010, Mitchell C. Shultz, an assistant clinical professor at the Jules Stein Eye Institute at UCLA, wrote, “Ophthalmologists now perform approximately three million cataract surgeries annually in this country. At a conservative rate of 0.5 percent of retinal detachments following cataract surgery, at least 15,000 detachments occur nationally every year after cataract surgery.”

In the population older than 50, Schultz wrote, cataract surgery “is increasing the risk of detachment by as much as 10-fold.”

Why the increased risk? Within a year of cataract surgery, “it is common to get a posterior vitreous separation because the surgery alters the physiology of the vitreous jelly [in the eyeball]. It becomes more liquid, and as it liquefies, it tends to detach from the back of the eye,” said Gordon Byrnes, an ophthalmologist and retinal surgeon with the Retina Group of Washington.

Still, there is disagreement on how significant a risk factor cataract surgery is for retinal detachment. A large 2012 study suggested that the risk was dropping: From 1989 to 1993, one in 100 cataract surgery patients later experienced retinal detachment, whereas from 1999 to 2001, the rate was only one in 400. The researchers attributed the change to improvements in surgical technology.

William L. Rich III, a Falls Church-based ophthalmologist, said, “In 37 years of operating on cataracts — over 13,000 surgeries — I have seen a grand total of one tear during the first three to six weeks after surgery. By far and away the major cause of detached retinas is degenerative, age-related posterior vitreous separation.”

–Bill Holleran

 
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