Predispostions for Detached Retina

I have percentages indicating that approximately 1% of cataract surgeries have detached retinas (not sure over what period of time post surgery).  I have also read that an IOL implant (a specific brand multi-focal) doubles that risk to 2%.  Statistically small unless it happens to you.  However, I am interested in knowing if there are any statistic regarding risks that make you more predisposed for detached retina with all the related problems that can follow for those that are over 50 (or 60 and over) AND are nearsighted. Duke49

[Ray T Oyakawa, MD]

The incidence of post operative retinal detachment for a multifocal or monofocal is the same.  The incidence of retinal detachment after cataract is much lower than 1%. Probably less than 1 in 500.

No relationship to AMD.  However, there is a relationship to myopia.  The chance of RD decrease in males over 50 who have had a posterior vitreous detachment.

Dr. O.

[AppleBr]

Decrease in in males over 50 with posterior vitreous detach?
Only males and only vitreous one? What a pity!
Well 50 is still far away from me...

[Duke49]

Revised Question:
I have percentages provided from the web site: Guest Expert/“Cataract Surgery Complications” indicating that in the U.S. the lifetime risk for a detached retina as a cataract complication is approximately 1% AND that the number rises to about 2% with YAG laser capsulatomy (note: the Restor IOL is more likely to require YAG than standard IOL per ReSTOR’s Information Brochure and other sources). I have also read that risks are higher for nearsighted adults and suspect the risks are even higher for those 50 plus or 60 plus. Are there any statistics available for this subgroup within the larger statistical group? This seems like data that should be available to for physicians to better advise patients. Thanks for any help you can provide. Duke49

[Ray T Oyakawa, MD]

Unfortunately, most of the statistics on retinal detachment include extracapsular cataract surgery with large incisions.  Modern phaco emulsification did not reach 50% use until 1995.

Back in 1977 when I started my residency the incidence of retinal detachment was about 4.5%.  In the early 1990 it decreased to about 1.5% with phacoemulsification.  My incidence is less than 1/500.

As mentioned nearsighted increase risk but decreases after a posterior vitreous detachment.  The detachment of the vitreous causes retinal tears.

Yes, Restor and any multifocal or accommodating IOL will have a higher incidence of YAGs and probably a higher incidence or retinal detachment.  

I recommend a standard IOL for you.

Dr. O.

[Duke49]

I really appreciate your reply to my revised question.  Am I to assume there are no statistics re: retina detachment for nearsighted 60+  patients who have no or very little posterior vitreous detachment?  Also, in same age group, is there no higher risk for males than females? Duke49