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

Abstract

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.