Update on a long-term, prospective study of capsulotomy and retinal detachment rates after cataract surgery

J Cataract Refract Surg. 2000 Jul;26(7):1017-21. doi: 10.1016/s0886-3350(00)00304-7.


Purpose: To evaluate the retinal detachment risks and neodymium:YAG (Nd:YAG) capsulotomy rates associated with different cataract approaches and intraocular lens (IOL) styles in a long-term,prospective clinical study.

Setting: Clinical practice of 1 ophthalmologist, Fort Collins, Colorado, USA.

Methods: Prospectively studied were surgical approach, date, and complications; IOL type; axial length; patient age and sex; Nd:YAG capsulotomy and date; and retinal detachment and date.

Results: Phacoemulsification had a lower risk of retinal detachment than intracapsular cataract extraction (ICCE) (0.4% versus 5.4%; P <.001) and extracapsular cataract extraction (ECCE) (0.4% versus 1.6%; P =. 002). Although retinal detachment was significantly associated with Nd:YAG for ECCE (3.1% versus 1.0%; P =.01), no patient in the phacoemulsification group had a retinal detachment after an Nd:YAG treatment. Retinal detachment was strongly associated with axial length of 24.0 mm and greater (P <.001), age of 60 years or less if axial length was 24.0 mm or greater (for ECCE, P =.001; for phacoemulsification, P =.01) and sex; that is, male (for ECCE, P =. 04; for phacoemulsification, P =.02). Regarding IOL styles the Surgidev B20/20 (P <.001) and AcrySof MA60 (P <.001) had significantly lower Nd:YAG rates, while the Cilco UPB 320 GS had a significantly higher Nd:YAG rate (P <.001).

Conclusions: Cataract surgical approach and IOL style significantly affect Nd:YAG and retinal detachment rates. Being a man, being 60 years or younger, and especially having an axial length of 24.0 mm or greater were associated with detachment. Some Nd:YAG approaches may not put the patient at increased risk for retinal detachment.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cataract Extraction / adverse effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Laser Therapy
  • Lens Capsule, Crystalline / surgery*
  • Lens Implantation, Intraocular
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prospective Studies
  • Retinal Detachment / etiology*
  • Risk Factors
  • Visual Acuity