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Incidence and risk factors for retinal detachment after cataract surgery in Korea: a nationwide population-based study from 2011 to 2015

Graefe's Archive for Clinical and Experimental Ophthalmology volume 257, pages 2193–2202 (2019)Cite this article

Abstract

Purpose

To evaluate the incidence and risk factors for retinal detachment (RD) after cataract surgery in the years 2011 to 2015 in Korea.

Methods

A nationwide retrospective cohort study was performed using health claim data from the Korean National Health Insurance Service (KNHIS) database. Patients over 40 years of age who underwent cataract surgery from 2011 and 2015 in Korea were retrospectively identified using Korean Electronic Data Interchange (KEDI) code and Korean Classification of Diseases (KCD)-7 code.

Results

A total of 2,191,510 eyes in 1,455,968 patients (58.63% female; mean age, 69.19 ± 9.82 years) underwent cataract surgery from 2011 to 2015 in Korea and 17,351 patients experienced RD (45.4% female; mean age, 60.89 ± 10.21 years). The 5-year cumulative risk of RD after cataract surgery was 1.19%, and 80.9% of RD occurred within 1 year after cataract surgery. In multivariate analysis, adjusted hazard ratio (HR) of RD was 1.335 [95% confidence interval (CI), 1.293–1.378] for male gender, 1.422 [95% CI, 1.371–1.475] for preoperative myopia, and 2.596 [95% CI, 2.367–2.849] for anterior vitrectomy during cataract surgery. Younger age was one of the factors highly associated with RD after cataract surgery, with HR [95% CI], 5.873 [5.527–6.240] in 40 to 54 years of age, 4.037 [3.811–4.277] in 55 to 64 years, and 2.026 [1.911–2.147] in 65 to 74 years. Adjusted HR of RD for surgery in secondary and primary healthcare centers were 0.495 [95% CI, 0.477–0.513] and 0.108 [95% CI, 0.104–0.113], respectively. Residence in non-metropolitan area and lower household income was associated with higher risk of RD.

Conclusions

Younger age, anterior vitrectomy for posterior capsule rupture, preoperative myopia, male gender, surgery in tertiary referral centers, residence in non-metropolitan area, and lower household income were associated with an increased risk of RD after cataract surgery. The optimal timing of cataract surgery should be determined considering patient’s risk factors, and appropriate pre- and postoperative evaluation is needed to prevent RD in patients with higher risks.

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Acknowledgments

This study used data from the NHIS-NCS 2002-2016, which was released by the KNHIS.

Funding

This work was supported by a National Health Insurance Ilsan Hospital grant (NHIMC2018-20-016).

Author information

Author notes

  1. Jiwon Kim and Sun Young Ryu contributed equally to this work.

Affiliations

  1. Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, #100 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi-do, 410-719, Korea

    Jiwon Kim, Sun Young Ryu & Eun Jee Chung

  2. Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea

    Sun Young Ryu

  3. Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Korea

    Jung Hwa Hong

Authors
  1. Jiwon Kim
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  2. Sun Young Ryu
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  4. Eun Jee Chung
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Correspondence to Eun Jee Chung.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the Institutional Review Board of the National Health Insurance Service Ilsan Hospital, Gyeonggi-do, Korea and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The requirement for written informed consent was waived because of the retrospective study design.

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Cite this article

Kim, J., Ryu, S.Y., Hong, J.H. et al. Incidence and risk factors for retinal detachment after cataract surgery in Korea: a nationwide population-based study from 2011 to 2015. Graefes Arch Clin Exp Ophthalmol 257, 2193–2202 (2019). https://doi.org/10.1007/s00417-019-04423-x

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  • DOI: https://doi.org/10.1007/s00417-019-04423-x

Keywords

  • Cataract surgery
  • Epidemiology
  • Population-based study
  • Retinal detachment