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Two studies show cataract surgery is riskier in younger patients

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Two Studies Show Cataract Surgery is Riskier in Younger Patients

A long-term, population-wide study conducted by researchers in Auckland, New Zealand, has found that the rate of rhegmatogenous retinal detachment (RRD) occurred nearly five times more frequently in patients younger than 50 years of age. Of the 1,793 consecutive patients having cataract surgery by phacoemulsification, RRD occurred in 1.17%. In patients younger than 50 years of age, the rate was 5.17%. The rate was considerably less in those older than 70 years (0.64%).

The median interval between cataract surgery and development of the retinal detachment was 39 months. The rate of retinal detachment was greater with complicated cataract surgery, but there was no increased risk for those eyes requiring Nd:YAG laser capsulotomy.

The study concluded that the overall risk for RRD after cataract surgery by phacoemulsification was small. However, in the younger patient, the risk for pseudophakic detachment was far higher. In light of this finding, the study recommended that the requirement for cataract surgery in this group be reassessed.

About these data: Pseudophakic retinal detachment after phacoemulsification cataract surgery: Ten-year retrospective review. Russell, M et al. J Cataract Refract Surg. 2006; 32(3):442-445.

A second study conducted to evaluate intraoperative performance and long-term outcome of phacoemulsification in patients younger than 50 years of age found that young patients pose a challenge in creating a capsulorrhexis and display significant incidence of intraoperative and postoperative posterior capsular opacification (PCO).

The study, conducted in Ahmedabad, India, was made up of 54 patients, all younger than 50 years of age, who had phacoemulsification. The mean patient age was 42.7 ± 5.2 years (men) and 43.1 ± 3.25 years (women). Continuous curvilinear capsulorrhexis was achieved in 49 patients (90.7%). Intraoperative PCO was present in (25.92%) 14 patients. An Nd:YAG laser posterior capsulotomy was performed in four patients (28.5%). Posterior capsule rupture leading to vitreous loss occurred in one patient (1.85%). At 3-year follow-up, endothelial cell loss was 5.9%. Postoperative PCO developed in eight patients (22.2%), and Nd:YAG laser posterior capsulotomy was performed in five patients (13.8%). The BCVA was �20/40 in 47 patients (94%). OM

About these data: Prospective evaluation of phacoemulsification in adults younger than 50 years Dholakia, S et al. J Cataract Refract Surg. 2005;31:1327-1333.