Incidence, Prevalence, and Risk of Retinal Detachment and Tears Up to 10 Years After Phacoemulsification in a Large US Cohort.

Purpose: To evaluate the short-term and long-term incidence and prevalence of retinal detachment (RD) and retinal tear, in addition to the relative risk (RR) of RD and retinal tear development following phacoemulsification.

Methods

Patients who received bilateral phacoemulsification were identified through US-based electronic health records, with incidence and prevalence of RD and retinal tear reported. The second objective was a retrospective cohort design with greedy nearest neighbor 1:1 propensity score matching based on age, sex, race, ethnicity, and known risk factors for RD and retinal tear. Matched cohort analysis was reported as RR with 95% CI at 1 month, 3 months, 6 months, 1 year, 3 years, 5 years, and 10 years after phacoemulsification.

Results

There were 742 337 patients identified. The prevalence of RD after phacoemulsification increased from 0.27% at 1 month to 1.41% at 10 years, while prevalence of retinal tear increased from 0.16% at 1 month to 0.97 % at 10 years. The highest incidence of RD and retinal tear occurred between 1 and 3 years in 0.37% and 0.27% of patients, respectively. Among 731 362 matched patients, phacoemulsification was associated with a significantly increased risk of RD and retinal tear from 3 months to 10 years. The RR of retinal tear peaked at 1 year (1.54; 95% CI, 1.46-1.63), and the RR of RD peaked at 3 years (1.57; 95% CI, 1.52-1.62).

Conclusions

Phacoemulsification is associated with sustained increases in RD and retinal tear risk even among patients matched for baseline risk. These findings underscore the need for long-term monitoring and education on potential complications.