Incidence Of Retinal Detachment Research Articles

Retinal detachment in Type IX collagen recessive Stickler syndrome.

Stickler Syndrome (SS) is associated with eye, joint and orofacial abnormalities. Most cases are dominantly inherited through COL2A1/COL11A1 variants encoding type-II/XI collagen, with patients having up to 78% retinal detachment (RD) risk. Rarer cases of recessive SS have also been identified, associated with pathogenic variants of genes including COL9A1, COL9A2 & COL9A3 encoding type-IX collagen, but there is limited published data on patients' phenotype or RD risk. Our study aimed to investigate RD risk in type-IX recessive SS, determining whether patients would benefit from prophylactic retinopexy. A secondary objective was to explore patient phenotypes, identifying key features which clinicians should identify, leading to earlier diagnosis. We report 13 cases from 11 families with Type-IX recessive SS, identified from the cohort attending the NHS England Highly Specialised Stickler Syndrome Service (1/1/15-31/12/22). Patients underwent multidisciplinary assessment by ophthalmology, rheumatology and audiology. 6/11 families exhibited previously undescribed genetic variants, and 7 had consanguineous parents. Clinical findings included abnormal vitreous architecture and high myopia. 15.4% of patients developed RD secondary to horseshoe retinal tears, with no cases of bilateral RD or giant retinal tears (GRTs). No patients had cleft palate, and 30.8% had midfacial hypoplasia. Hearing loss was more prevalent (91.7%) than in dominant SS. Arthropathy was uncommon but variable in manifestation. Ours results do not point to high RD nor GRT incidence in recessive SS, although given the rarity, our numbers are small. Prophylactic retinopexy should only be offered case-by-case for fellow eyes of patients presenting with GRT detachments in their first eye.

Risk factors for early and late retinal detachment after boston type I keratoprosthesis surgery.

To determine the differential risk factors for retinal detachment (RD) after Boston Type 1 Keratoprosthesis (B1KPro) during the first year after surgery (early RD; ERD) and afterwards (late RD; LRD). Retrospective cohort study of 94 eyes (90 patients) undergoing B1KPro implantation at Centro de Oftalmología Barraquer from June 2006 to July 2022 with a minimum follow-up of one year. The incidence of RD in the whole sample after B1KPro implantation was 29% (27/94), occurring in 21% of eyes (ERD; 20/94) the first year, and in 7% afterwards (LRD; 7/94). Hypotony was revealed as a significant risk factor for ERD (16/19 = 84%; OR = 14.5, P < 0.0001), together with aphakia (16/20 = 80%; OR = 5.9, P = 0.004), intraocular lens (IOL) removal (4/8 = 50%; OR = 6.2, P = 0.03), previous choroidal detachment (CD; 7/20 = 35%; OR = 35.5, P = 0.001) and previous pars plana vitrectomy (PPV; 15/20 = 75%; OR = 6.6, P = 0.006). Multivariate analysis included hypotony and PPV at any time as variables significantly associated with ERD occurrence. The occurrence of LRD was significantly related to peripheral retinal changes, detected few days before (4/6 = 66%; OR = 65, P < 0.0001). Hypotony emerged as one of the main factors influencing ERD occurrence after B1KPro implantation. Additionally, previous CD, PPV, aphakia, and IOL removal should be considered to estimate the risk of postoperative retinal detachment. In contrast, peripheral retinal changes after B1KPro seem to be significantly related to LRD occurrence. This study reinforces the need for frequent intraocular pressure evaluation, and comprehensive periodic retinal assessment over time. What is known Retinal detachment (RD) is a severe complication after Boston Type 1 Keratoprosthesis (B1KPro) implantation, resulting in a permanent reduction of visual acuity in a clinically relevant percentage of eyes. The time of RD occurrence after B1KPro implantation differs in the literature but is reported to be more common within the first year. Previous aphakia, choroidal detachment, or RD repair, intraocular lens removal, vitritis, or history of Nd-YAG laser have been described as risk factors for RD after B1KPro surgery in samples with varying follow-ups. Multivariate analysis in the first year after B1KPro surgery showed hypotony and pars plana vitrectomy at any time as significant risk factors for early RD. Late RD cases, occurring after one year following the B1KPro surgery, seem to be significantly related to peripheral retinal changes suffered a few days before loss of visual acuity and RD diagnosis. It is plausible to think that risk factors for RD after B1KPro differ in short and long postoperative times.

Use of intravitreal antiviral injection during vitrectomy in the treatment of acute retinal necrosis: anatomic and visual outcomes

PurposeTo investigate whether intravitreal antiviral injection (IAI) during vitrectomy reduces the postsurgical retinal detachment (RD) rate and improves the visual prognosis of patients with acute retinal necrosis (ARN).MethodsThis retrospective cohort study included ARN patients treated at a tertiary hospital between January 2013 and December 2020. Patients who underwent pars plana vitrectomy (PPV) alone or combined with intraoperative IAI were classified in PPV-only group and PPV + IAI group, respectively. The incidence of postsurgical RD and the best corrected visual acuity (BCVA) between the groups was compared. A multivariate Cox hazard analysis was employed to explore the risk factors of postsurgical RD. A multivariate logistic regression analysis was applied to assess the impact of intraoperative IAI on preventing severe vision loss (SVL).ResultsFifty-seven eyes with ARN with a median follow-up of 18.5 months were included in the study. There was no significant association between intraoperative IAI during vitrectomy and a reduced risk of postsurgical RD (hazard ratio [HR], 2.65; 95% CI, 0.71–9.89) or SVL at the 6-month follow-up visit (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.25–3.35). Better baseline best-corrected visual acuity (BCVA) was identified to associate with a higher risk of postsurgical RD (HR, 0.33; 95% CI, 0.14–0.81) and a lower risk of SVL at 6 months (OR, 2.28; 95% CI, 1.10–4.89).ConclusionWe did not observe a significant effect of intraoperative IAI on the anatomic and visual outcomes of ARN patients in this study. Intraoperative IAI may not be a necessary treatment option for ARN patients who receive vitrectomy.

Retinal Detachment Following Cataract Surgery: A Systematic Review and Meta-analysis of Incidence, Preoperative Risk Factors, and Postoperative Complications.

Cataract surgery is the most common surgical operation in the developed world, for treating cataracts, currently the leading cause of blindness worldwide. Retinal detachment (RD) is a potentially sight-threatening adverse effect of cataract surgery. The overall RD case numbers are high due to the common practice of cataract surgery. The Medline, Scopus, and Directory of Open Access Journals databases were searched for relevant articles using the keywords (phacoemulsification OR cataract surgery) AND (retinal detachment, detached retina). The included studies involved 5,480,448 patients, where 36,886 had RD (pooled incidence: 0.66 events per 100 patients, 95% CI 0.43 to 1.00). Male patients had significantly higher odds of developing RD than female patients (odds ratio = 1.73, 95% CI 1.68 to 1.78, P < 0.001). The RD incidence rate across locations was not significantly different. RD is one of the most significant complications following cataract surgery. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].

Retinal Tear and Retinal Detachment after Cataract Surgery in Eyes with a Previous History of Treated Phakic Retinal Tears

ObjectiveTo investigate the incidence and outcomes of retinal tear (RT) and retinal detachment (RD) after cataract extraction in patients with a history of previous phakic RT. DesignRetrospective case series. SubjectsPhakic eyes with RT that were successfully treated with laser photocoagulation or cryotherapy and subsequently underwent cataract surgery. MethodA retrospective review of phakic eyes treated for RTs between April 1, 2012 and May 31, 2023 was performed. Exclusions included prior vitreoretinal surgery before cataract removal and follow-up of less than 6 months post-cataract surgery. Main outcome measuresThe incidence of RTs and RDs after cataract surgery, along with visual and anatomic outcomes. ResultsOf 12,109 phakic eyes treated for RTs, 1039 (8.6%) eyes underwent cataract surgery. After exclusions, 713 eyes of 660 patients were studied. The mean (standard deviation, SD) follow-up period post-cataract surgery was 34.8 (24.6) months with a median of 239 and 246 days to a new RT or RD development. The overall incidence for diagnosis of post-cataract surgery RT and RD was 7.3% (52/713) (2.9% and 4.3%, respectively), with a one-year incidence of 5.6% (2.2% and 3.4%, respectively). Multivariable regression analysis identified a higher risk of RT/RD among younger individuals (odds ratio [OR] 1.034; 95% confidence interval [CI] 1.004-1.065, P=0.028), males (OR 2.058; 95% CI 1.110-3.816, P=0.022), and those with shorter interval between laser treatment and cataract surgery (OR 1.001; 95% CI 1.001-1.001, P=0.011). Single surgery anatomic success for the RD repair was achieved in 25 eyes (80.6%) at 3 months, with a 100% final reattachment rate. The median final logMAR visual acuity was 0.10 (20/25) for RT, showing no significant change from post-cataract surgery, and 0.18 (20/30) for RD, a significant worsening from after cataract surgery. ConclusionOne year post-cataract surgery, the rate of diagnosed RT and RD in patients with previously treated RTs was relatively high, occurring in nearly 1 in 18 eyes. Higher risk was noted among younger individuals, males, and patients with a shorter interval between initial treatment for RT and cataract surgery. RD repair achieved good anatomical results, but vision declined.

Outcomes of Postcataract Surgery Endophthalmitis Managed Without Microbial Cultures

To evaluate outcomes of eyes with post-cataract surgery endophthalmitis that were managed without microbial cultures. This retrospective, single-center comparative cohort study identified all cases of endophthalmitis after cataract surgery presenting between February 1, 2014, and November 1, 2022. All eyes presenting with presumed endophthalmitis requiring in-office treatment with intravitreal antibiotics and either a vitreous or aqueous tap were included. Endophthalmitis cases were divided into the "culture group" if the vitreous or aqueous specimens were sent for microbiologic sampling or into the "no culture group" if an aqueous or vitreous tap was performed but not sent for microbiologic sampling. Best corrected visual acuity (VA) 12 months following endophthalmitis presentation, incidence of retinal detachment, and need for subsequent procedures. Of the 232 endophthalmitis cases identified, 196 (85%) were in the "culture group" and 36 (15%) were in the "no culture group". At endophthalmitis presentation, eyes in the "culture group" had a mean (SD) logMAR VA [Snellen Equivalent] of 2.14 (0.8) [20/2760] and mean (SD) logMAR VA in the "no culture group" was 1.93 (0.8) [20/1702] (p=0.185). At 12-month follow up, mean (SD) logMAR VA for the "culture group" was 0.80 (1.0) [20/126] and 0.41 (0.5) [20/50] in the "no culture group" (adjusted difference = 0.41, 95% CI = -0.043 - 0.857, p=0.076). Twenty of 196 (10%) eyes in the "culture group" developed secondary retinal detachments within 12 months of presentation compared to 0 in the "no culture group" (p=0.045). Eyes with endophthalmitis following cataract surgery managed without microbiologic cultures have similar visual outcomes to eyes managed with microbiologic cultures and may be less likely to develop secondary retinal detachments. This may be an acceptable strategy to manage endophthalmitis after cataract surgery when prompt access to a microbiologic facility is unavailable.

Outcomes of Cataract Surgery in Eyes With Axial Length > 33 mm

To evaluate the visual outcomes and perioperative complications for cataract surgery in eyes with axial length (AL) >33.0 mm. Prospective clinical cohort study. One hundred twenty-two eyes with moderate high myopia (26.0 mm ≤ AL < 28.0 mm, control group), and 118 eyes with extreme high myopia (AL > 33.0 mm, EHM group) were followed up after cataract surgery (1 week and 1 year post-op). Myopic maculopathy grading according to ATN system, best-corrected visual acuity (BCVA), and complications were compared. Postoperatively, BCVA in the EHM group improved significantly at both visits (both P < .001), despite being worse than that of the control group (both P < .05). The EHM group exhibited greater hyperopic refractive errors (P < .001), which were found to be associated with more severe T grade, longer AL, poorer second follow-up BCVA, and smaller anterior capsular opening (ACO) area. A higher incidence of retinal detachment and a more constricted ACO were observed in the EHM group (P = .030 and <.001, respectively), with the latter being significantly associated with longer AL and the absence of capsular tension ring (both P < .05). No difference in BCVA was found between the aphakic and pseudophakic eyes in the EHM group at both visits (both P > .05). Cataract surgery improves vision of eyes with AL >33 mm, yet the increased risk of perioperative complications requires attention. Leaving these eyes aphakic might be effective and safe in the long term.

Genotype-phenotype Correlations of Ocular Posterior Segment Abnormalities in Marfan Syndrome

PurposeMarfan syndrome (MFS) is a connective tissue disorder caused by mutations in the FBN1 gene. In addition to typical phenotypes such as ectopia lentis and aortic dilation, MFS patients are prone to ocular posterior segment abnormalities, including retinal detachment, maculopathy, and posterior staphyloma. This study aims to investigate the correlations between FBN1 genotype and posterior segment abnormalities within a Chinese cohort of MFS. DesignRetrospective study. Participants121 eyes of 121 patients with confirmed FBN1 mutations between January 2015 and May 2023 were included. MethodsComprehensive ophthalmological exam findings were reviewed, and the incidence of retinal detachment, atrophic / tractional / neovascular maculopathy (ATN classification system) and posterior staphyloma was analyzed between different genotype groups. Only the more severely affected eye from each patient was included. Main outcome measuresClinical features and risk factors. ResultsOut of 121 patients, 60 eyes (49.59%) exhibited posterior segment abnormalities, including retinal detachment (4, 3.31%), maculopathy (47, 38.84%), and posterior staphyloma (54, 44.63%). The mean age was 11.53 ± 11.66 years, with 79.34% of patients below 20 years old. The location and region of mutations were found to be associated with the incidence of maculopathy (P = 0.013, P = 0.033) and posterior staphyloma (P = 0.043, P = 0.036). Mutations in the middle region had a lower incidence of maculopathy and posterior staphyloma (P = 0.028 and P = 0.006, respectively) than those in C-terminal region. Mutations in the TGF-β regulating sequence exhibited a higher incidence of maculopathy and posterior staphyloma (P = 0.020, P = 0.040). Importantly, the location and region of mutations were also associated with the incidence of atrophic maculopathy (P = 0.013 and P = 0.033, respectively). Mutations in the middle region had a significantly lower probability of atrophic maculopathy (P = 0.006), while mutations in the TGF-β regulating sequence had a higher incidence of atrophic maculopathy (P = 0.020). ConclusionMaculopathy and posterior staphyloma were associated with the location and region of FBN1 mutations. Patients with mutations in the TGF-β regulating sequence faced an increased risk of developing retinopathy.

Ultrasound of the eye – Part 2: Fundamentals of posterior wall detachment

AbstractDetachment of the posterior membranes of the eye may occur following trauma or surgery, can result from certain disease processes or just be attributed to the aging process. Irrespective of the cause, all can contribute to visual disturbance. Failure to diagnose and treat such conditions can have permanent effects on a patient's vision if not addressed in a timely manner. Ultrasound proves to be a useful tool to aid in the diagnosis of posterior wall detachments when the operator has a thorough knowledge of ocular structure and function, anatomical landmarks and the common sonographic appearances that differentiate the type of membrane involved in the disease process. Although ocular ultrasound has historically been performed in the emergency or ophthalmology settings, the incidence of ocular ultrasound being undertaken in radiology departments is increasing. Multiple recent studies have observed an increase in the incidence of retinal detachment, the main causative factors being linked to a higher prevalence of myopia and cataract surgeries. The purpose of this article therefore is to provide a comprehensive guide to the anatomical structure of the posterior orbital segment, including surface anatomy and attachment points, and how this can facilitate the correct identification of the different types of posterior membranous detachment based on common sonographic appearances. As such, operators skilled in performing ultrasound of the eye can play a pivotal role in ensuring an appropriate management pathway is achieved by way of accurate interpretation of pathological ultrasound images.

Effect of Lensectomy on Incidence of Retinal Detachment in Non-Traumatic Ectopia Lentis

Effect of Lensectomy on Incidence of Retinal Detachment in Non-Traumatic Ectopia Lentis

INCIDENCE AND DEPENDENCE OF FUNCTIONAL RETINAL CHANGES IN RHEGMATOGENOUS DETACHMENT IN PATIENTS OF DIFFERENT AGE GROUPS

Introduction. Rhegmatogenous retinal detachment results from retinal rupture causing the accumulation of fluid with the separation of the neurosensory retina from the main pigment epithelium. This condition is known as the most common type of retinal detachment. Patients with newly developed retinal detachment typically experience a sudden loss of vision, accompanied by floating opacities and metamorphopsia, or a "dark veil," that interferes with vision. The annual incidence of retinal detachment has been estimated in different countries and regions for a long time and ranged from 6.9 to 26.2 cases per 100,000.&#x0D; Aim of this study is to investigate the incidence rate of rhegmatogenous retinal detachment among individuals of different age groups.&#x0D; Materials and methods. 240 patients with rhegmatogenous retinal detachment operated during 2022-2023 were included in this retrospective study. The criteria for inclusion were the following: a case of retinal detachment with onset between January 2022 and October 2023. Exclusion criteria include: 1) traction-induced retinal detachment (eg, proliferative diabetic retinopathy), iatrogenic injury, or eye tumor; 2) subclinical RBS, which could be cured by one laser treatment of the retina; 4) a history of penetrating eye injury; 5) retinal detachment caused by a macular tear.&#x0D; Results and conclusions. Following the analysis of the incidence of rhegmatogenous retinal detachment, it was observed that this condition predominantly occurs in men (62.5% of cases), particularly in the older age group (60-70 years). The average duration of detachment before surgical intervention is 18.4±2.4 days. Early detection of rhegmatogenous retinal detachment leads to a reduced risk of total retinal detachment with macular involvement, as evidenced in our study (63.3% macula-off in men compared to only 28.8% macula-off in women).

Outcomes of Retinal Detachment after Open-Globe Injury, and Independent Validation of the Retinal Detachment after Open-Globe Injury Scoring System

To independently validate the retinal detachment (RD) after open globe injury (OGI) score (RD-OGI Score) as a clinical prediction model for estimating the risk of RD after OGI, and to characterize outcomes of RD stratified by RD-OGI risk category. Retrospective, multi-institutional cohort study. A validation cohort of 236 eyes with OGI managed at two U.S. academic institutions from 2017-2021 was compared to the predictions of the RD-OGI Score model and to the derivation cohort of 893 eyes with OGI used to develop the RD-OGI Score model. RD-OGI Scores were calculated and patients were stratified into three risk groups (low, moderate, and high) for analysis. The incidence of RD in the validation cohort was used to calculate standard performance metrics to evaluate predictive accuracy of the RD-OGI Score. Area under the curve (AUC), sensitivity, specificity, and accuracy of the RD-OGI Score; anatomic success (retina attached or detached) and best corrected visual acuity (BCVA) at last follow-up. In the validation cohort, 92 of 236 eyes (39%) developed RD after OGI. The RD incidence predicted by the RD-OGI Score was strongly correlated with actual RD incidence in the validation cohort (Spearman ρ= 0.92, P<0.001). The RD-OGI Score demonstrated a high discriminativeness with the validation cohort (AUC= 0.84, 95% CI: 0.79-0.89). An RD-OGI Score of 2.5 was found to have 73% accuracy, 93% sensitivity, and 60% specificity for predicting no RD (RD-OGI <2.5) versus RD (RD-OGI ≥2.5). Median BCVA at last follow-up for successfully reattached eyes was comparable for high risk (∼20/380) and moderate risk (∼20/300) eyes (P>0.99), but both were significantly worse compared to low risk eyes (∼20/25 Snellen) (P=0.010). The RD-OGI Score reliably predicts the risk of developing RD after OGI. In eyes that develop RD, a higher RD-OGI Score is strongly correlated with a greater risk for poor functional and anatomic outcomes. An RD-OGI Score ≥2.5 identifies eyes at substantial risk for RD and adverse outcomes and may serve as a useful cutoff for guiding referral to a vitreoretinal surgeon after primary globe closure.

Классификации периферических дистрофий сетчатки

Purpose. To analyze the existing classifications of peripheral retinal dystrophies. Material and methods. While writing a literature review, a search was made for data from domestic and foreign literature, mostly in the last 20 years. The search was carried out using the following keywords: «peripheral retinal dystrophies», «retinal detachment», «laser coagulation», «lattice degeneration». In total, 20 articles were selected that relate to the topic of this literature review. Results. Retinal detachment is a severe pathology leading to a significant reduction or loss of vision. Peripheral retinal dystrophies play a leading role in the development of retinal detachment. The leading role in the development of rhegmatogenous forms of peripheral degenerations is assigned to changes in the vitreous body with a traction effect on the retina. The question of the incidence of retinal detachment in its dystrophies remains debatable. In publications, we came across a large number of classifications of peripheral retinal dystrophies, covering from 8 to 20 different clinical forms. The question of which retinal dystrophies are predisposing or not predisposing to retinal detachment remains open. Visualization of the vitreoretinal interface in peripheral degenerations is relevant for determining treatment tactics. Optical coherence tomography is highly informative in the early diagnosis of the traction component, visualization of retinal tears and detachment, and determination of indications for laser coagulation of the retina. Conclusion. Retinal detachment is a severe pathology leading to a significant reduction or loss of vision. Peripheral retinal dystrophies play a leading role in the development of retinal detachment. The question of the incidence of retinal detachment in its dystrophies remains debatable. The issue of creating a working classification that reflects the morphology of the degenerative process and indications for laser treatment remains relevant. Key words: peripheral retinal dystrophy, retinal detachment, retinal laser treatment, lattice degeneration

Are Retinal Detachments Becoming More Frequent? Data from 2 University Eye Clinics and Literature Review.

ZusammenfassungAusgehend vom subjektiven Eindruck vieler vitreoretinaler Chirurgen und der Beobachtung stark steigender Zahlen von Patienten mit Netzhautablösungen an einzelnen Zentren in den letzten Jahren, wurde die jüngere Literatur zu Veränderungen der Inzidenz der Netzhautablösungen weltweit gesichtet. Dabei zeigten sich ganz erhebliche methodische Unterschiede der Studien, die einen Vergleich und klare Schlussfolgerungen zur Entwicklung der Häufigkeit von Netzhautablösungen erschweren. Trotz dieser Einschränkungen sprechen alle Daten aus aktuellen Untersuchungen für eine Zunahme der Zahl der Netzhautablösungen. Die Ablatio-Inzidenz in der westlichen Welt scheint derzeit bei über 20 Fällen pro 100 000 Personenjahren zu liegen, somit deutlich höher als in früheren Jahrzehnten beschrieben. Ursächlich kann vermutet werden, dass ein Anstieg der Prävalenz der Myopie, eine demografische Zunahme der Patienten im typischen Ablatio-Alter und eine steigende Zahl an Kataraktoperationen, insbesondere bei jüngeren Patienten, für die steigende Inzidenz der Ablatio verantwortlich sind.

Epidemiological characteristics of primary rhegmatogenous retinal detachment in the Udmurt Republic

Primary rhegmatogenous retinal detachment (RRD) is a severe, potentially disabling ophthalmic pathology that requires timely surgical treatment to prevent progressive loss of vision.Purpose. To analyze the incidence of RRD in the Udmurt Republic for the three-year period and to study an influence of clinical and sociodemographic factors to an occurrence of the studied pathology.Methods. Retrospective assessment of 523 clinical cases of the first time diagnosed primary rhegmatogenous retinal detachment for the period from 2019 to 2021 was conducted. Data analysis was performed on the basis of the Republican Ophthalmological Clinical Hospital of the Ministry of Health of Udmurt Republic.Results. The overall annual average RRD in the Udmurt Republic was 11.5 per 100,000 inhabitants (95% CI, 10.7–11.9). Men on average is more often than women (37.37 vs 32.17 respectively, p &lt; 0.05). However, in the group of 50 years and older the female sex prevails. The highest incidence was found in the age group of 60–69 years in both sexes. A right eye was affected more often (51.43%) than a left one (45.89%) but equally in both men and women (p = 0.515). In the most subjects (50.48%) refraction was myopic. It was found that the age of myopes among all the patients with RRD was statistically significantly less than among hypermetropes (p = 0.008) and emmetropes (p &lt; 0.001). Previous cataract extraction was noted in 21.22% that was 2.38 times more often in men (28%) than in women (15%, p &lt; 0.001) and the age was comparable.Conclusion. The obtained results of the rhegmatogenous retinal detachment incidence among the population of the Udmurt Republic are comparable with the incidence data of the most countries in Western Europe. The most significant risk factors for Udmurtia are male gender, old age, myopia and pseudophakia.

First Nation-Wide Study of the Incidence and Characteristics of Retinal Detachment in Poland during 2013–2019

The present study aimed to analyze the incidence and characteristics of all types of retinal detachment (RD) in the overall population of Polish adults during 2013-2019. Data from all levels of healthcare services at public and private institutions recorded in the National Health Fund (NHF) database were evaluated. International Classification of Diseases codes (ICD-9 and ICD-10) and unique NHF codes were used to identify RD patients and RD treatment procedures. In the period 2013-2019, 71,073 patients with RD were newly diagnosed in Poland. The average incidence was 32.64/100,000 person-years (95% CI: 31.28-33.99) and it increased with the age of patients, with the highest rate in the group of patients ≥70 years of age. The overall incidences of rhegmatogenous RD, traction RD, serous RD, other RD and unspecified RD were 13.72/100,000, 2.03/100,000, 1.02/100,000, 7.90/100,000 and 7.97/100,000 person-years, respectively. The most common surgical treatment for RD in Poland was PPV performed on average in 49.80% of RD patients. The risk factor analyses showed that rhegmatogenous RD was significantly associated with age (OR 1.026), male sex (OR 2.320), rural residence (OR 0.958), DM type 2 (OR 1.603), any DR (OR 2.109), myopia (OR 2.997), glaucoma (OR 2.169) and uveitis (OR 2.561). Traction RD was also significantly associated with age (OR 1.013) and male sex (OR 2.785) as well as with any DR (OR 2.493), myopia (OR 2.255), glaucoma (OR 1.904) and uveitis (OR 4.214). Serous RD was significantly associated with all analyzed risk factors except DM type 2. The total incidence of retinal detachment in Poland was higher than found in previously published studies. Our study demonstrated that diabetes type 1 and diabetic retinopathy are risk factors of development of serous RD, which is presumably associated with the disruption of the blood-retinal barriers in these conditions.

Commentary: Scleral penetration or perforation during strabismus surgery.

Commentary: Scleral penetration or perforation during strabismus surgery.

Incidence and Risk Factors for Retinal Detachment Following Cataract Surgery at a Tertiary Center in Jeddah, Saudi Arabia.

Introduction The incidence of retinal detachment in the general population is 0.08%, it has been reported to reach 0.7% or higher following cataract surgery. One of the most important risk factors for retinal detachment is posterior capsular rupture during cataract surgery. Additional risk factors include high myopia, history of ocular trauma, young age, male sex, and diabetes. In this study, we aimed to investigate the incidence and risk factors of retinal detachment following cataract surgery in patients treated at our hospital. Materials and methods This retrospective cohort study was conducted at King Abdulaziz University Hospital (KAUH), a tertiary center in Jeddah, Saudi Arabia. The medical records of 365 patients (365 eyes) who underwent cataract surgery from 2017 to 2021 were reviewed. Results The average age of the 365 patients was 63 years, and 47.7% (n=174) of patients were male. The incidence of retinal detachment was 3.3% (n=12). The risk of RD was 2.8 times higher for the right eye than for the left eye. The incidence of RD was significantly more in eyes with intraoperative posterior capsular rupture, zonular dehiscence, corneal trauma, and surgery combined with anterior vitrectomy than in other eyes. The most common complication of cataract surgery is corneal edema, which was observed in 22.7% of the eyes; our analysis revealed a significant relationship between corneal edema and the duration of surgery. Conclusion In our study, we highlighted the higher incidence of retinal detachment compared to those in other studies; most cases occurred one month postoperatively.

Incidence of Retinal Detachment, Macular Edema, and Ocular Hypertension after Neodymium:Yttrium-Aluminum-Garnet Capsulotomy: A Population-Based Nationwide Study—The French YAG 2 Study

To estimate the incidence and assess the risk factors associated with 3 adverse events (AEs) after neodymium:yttrium-aluminum-garnet posterior capsulotomy (Nd:YAG-caps): ocular hypertension (OHT), macular edema (ME), and retinal detachment (RD). Observational cohort study using a nationwide claims database. Adults who underwent Nd:YAG-caps between 2014 and 2017, with no ocular disease history in the year before. Patients who underwent Nd:YAG-caps were identified using data from the French national representative sample and followed up for 12 months postprocedure. The time to AE was assessed using the Kaplan-Meier method. Factors associated with AE were assessed using Cox models. Neodymium:YAG-caps epidemiology, patients' characteristics, proportion of patients with AE, and hazard ratios (HRs) associated with variables identified as factors associated with AEs. During the study period, 6210 patients received Nd:YAG-caps (7958 procedures). The mean age (± standard deviation) at Nd:YAG-caps was 75.0 (± 10.3) years. The 3-month and 12-month overall AE rates (≥ 1 AE of interest) were 8.6% and 13.3%, respectively. Among patients with ≥ 1 AE of interest, 68.4% of AEs occurred within 3 months post-Nd:YAG-caps. Three-month rates were ≈5% for OHT and ME. Retinal detachment remained ≤ 0.5% over follow-up. Cox models showed that patients with Nd:YAG-caps performed within 1 year after cataract surgery had a higher risk of AEs than those with later Nd:YAG-caps (hazard ratio [HR], 1.314 [1.034-1.669], P= 0.0256), notably ME (HR, 1.500 [1.087-2.070], P = 0.0137). Diabetic patients were more at risk of OHT (HR, 1.233 [1.005-1.513], P= 0.0448) and ME (HR, 1.810 [1.446-2.266], P < 0.0001) than nondiabetic patients. Patients with Nd:YAG-caps performed between 1 and 2 years after cataract surgery were more at risk of OHT than patients with later Nd:YAG-caps (HR, 1.429 [1.185-1.723], P= 0.0002). According to a national claims database, OHT and ME were the most frequent AEs of interest post-Nd:YAG-caps, mainly observed within 3 months postprocedure, highlighting the need for a close follow-up during this period or a delayed capsulotomy. Diabetes and an early Nd:YAG-caps after cataract surgery were among the main drivers for AE occurrence. Proprietary or commercial disclosure may be found after the references.

Risk Factors for Retinal Detachment RepairAfter Pediatric Cataract Surgery inthe United States.

To determine the cumulative incidence of retinal detachment (RD) repair following pediatric cataract surgery and identify the associated risk factors. US population-based insurance claims retrospective cohort study. Patients ≤ 18 years old who underwent cataract surgery in 2 large databases: Optum Clinformatics (2003-2021) and IBM MarketScan (2007-2016). Individuals with ≥ 6months of prior enrollment were included, and those with a history of RD, RD repair, traumatic cataract, spherophakia, or ectopia lentis were excluded. The primary outcome was time between initial cataract surgery and RD repair. The risk factors investigated included age, sex, persistent fetal vasculature (PFV), prematurity, intraocular lens (IOL) placement, and pars plana lensectomy approach. Kaplan-Meier estimated cumulative incidence of RD repair 5years after cataract surgery and hazard ratios (HRs) with 95% confidence intervals (CIs) from multivariable Cox proportional hazards regression models. Retinal detachment repair was performed on 47 of 3289 children included in this study. The cumulative incidence of RD repair within 5years of cataract surgery was 2.0% (95% CI, 1.3%-2.6%). Children requiring RD repair were more likely to have a history of prematurity or PFV and less likely to have an IOL placed (all P<0.001). Factors associated with RD repair in the multivariable analysis included a history of prematurity (HR, 6.89; 95% CI, 3.26-14.56; P < 0.001), PFV diagnosis (HR, 8.20; 95% CI, 4.11-16.37; P < 0.001), and IOL placement (HR, 0.44; 95% CI, 0.21-0.91; P=0.03). Age at surgery, sex, and pars plana lensectomy approach were not significantly associated with RD repair after adjusting for all other covariates. Approximately 2% of patients will undergo RD repair within 5years of pediatric cataract surgery. Children with a history of PFV and prematurity undergoing cataract surgery without IOL placement are at the greatest risk.