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. 2024 Jun 5:18:1623-1636.
doi: 10.2147/OPTH.S464005. eCollection 2024.

Incidence and Risk Factors for Retinal Detachment Following Pediatric Cataract Surgery

Mawaddah Sabr #  1 , Valmore A Semidey  2 , Marcos J Rubio-Caso  2 , Renad Aljuhani Jnr  3 , Gorka Sesma #  1
Affiliations

Incidence and Risk Factors for Retinal Detachment Following Pediatric Cataract Surgery

Mawaddah Sabr et al. Clin Ophthalmol. .

Abstract

Background: Retinal detachment is a major postsurgical threat in pediatric cataract surgery; however, the effect of axial length remains unclear. This study aimed to assess the relationship between axial length and detachment risk in vulnerable patients.

Methods: This retrospective cohort study analyzed 132 eyes of 84 pediatric cataract surgery patients aged <20 years old. Axial length was measured preoperatively, and the incidence of retinal detachment was recorded over a median follow-up of 4 years. Logistic regression analysis was used to examine the axial length-detachment relationship.

Results: Twenty eyes had postoperative retinal detachments. The median axial length was longer in the detachment group (23.6 mm) than in the non-detachment group (21.6 mm). Eyes with axial length ≤23.4 mm had 0.55-fold decreased odds of detachment compared to longer eyes. Preexisting myopia and glaucoma confer heightened risk. Approximately half of the patients retained some detachment risk eight years postoperatively.

Conclusion: Shorter eyes (axial length ≤23.4 mm) appear to be protected against pediatric retinal detachment after cataract surgery, whereas myopia, glaucoma, and axial elongation > 23.4 mm elevate the postoperative risk. Understanding these anatomical risk profiles requires surgical planning and follow-up care of children undergoing lensectomy.

Keywords: axial length; congenital cataract; congenital glaucoma; myopia; pediatric cataract surgery; retinal detachment.

Plain language summary

This study investigated the protective role of a shorter axial length in preventing retinal detachment after pediatric cataract surgery. This highlights the correlation between smaller eye sizes and reduced detachment risk, emphasizing the need for careful consideration of anatomical factors in surgical planning and patient monitoring, particularly for patients with preexisting myopia or postoperative glaucoma.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

None
Graphical abstract
Figure 1
Figure 1
Trend and Statistical Significance of Odds Ratios for Axial Length Based on p-values in Unadjusted Logistic Regression Analysis. The graph displays a dual-line representation of the relationship between the AL and the odds ratio in an unadjusted logistic regression analysis. The X-axis measures the AL in millimeters, while the first Y-axis (blue line with diamond spots) represents the odds ratios associated with each AL. This line demonstrates how the odds ratio changes as the AL increases, permitting the identification of trends such as increasing or decreasing probabilities related to different AL. The second Y-axis (Orange line with square spots) displays the corresponding p-values for each AL. The red dot line indicates the statistical significance of the odds ratios at various points, representing a p-value of ≤ 0.05.
Figure 2
Figure 2
Retinal Detachment Risk Over Time: A Survival Analysis. The Kaplan-Meier plot illustrates the probability of RD in relation to the time of cataract surgery. The x-axis shows the time of cataract surgery in years, whereas the y-axis shows the probability of RD. Each mark on the graph signifies the likelihood of individuals being at risk after cataract surgery. The plot depicts the progression of the probability over time.
See this image and copyright information in PMC

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