Predictive factors of retinal tear occurrence following cataract surgery

This study explores the incidence, features, timing, and risk factors related to patients with retinal tears (RT) after cataract surgery. The results augment the limited information on the prevalence and risk factors of RTs, which are important in the pathogenesis and treatment of rhegmatogenous retinal detachments (RRD).

Study design

This is a single center, retrospective chart review of 13,007 cataract surgery patients for 6 years (2014–2019) to evaluate the prevalence and risk factors of retinal tear and detachment within 1 year after phacoemulsification.

Outcomes

Within 1 year of cataract surgery, 79 patients developed RTs (0.6% of the 13,007 patients who were included in the analysis). Of the RTs detected, 43% were asymptomatic and 40.5% were diagnosed with concurrent retinal detachment. Risk factors associated with RTs include greater than 6 D axial length, prior refractive surgery, and intraoperative complications.

Limitations

Limitations include small sample size, potentially missed tears given the high number of asymptomatic tears or not having an evaluation with a retina specialist, and the relatively short follow-up period. As the study analyzed cases at a tertiary care center, potential referral bias also could have influenced results.

Clinical significance

Given the high percentage of asymptomatic tears, postoperative dilated exams in the first year after cataract surgery may help identify problematic pathology. Patients with long axial length and intraoperative complications were at highest risk for developing postoperative retinal tears.