Risk factors for retinal detachment after clear lens replacement outlined

April 18 - Washington, DC - Clear lens replacement is considered a good option for patients who are well-educated about the risk factors pertaining to retinal detachment, explained J. Pitzer Gills III, MD, who spoke during a cataract/refractive symposium on refractive lens exchange, bioptics, and intracorneal lenses during the American Society of Cataract and Refractive Surgery annual meeting.

In an ongoing study of 890 eyes that underwent clear lens exchange and were followed from 1997 to the present, Dr. Gills reported that eight retinal detachments had occurred out of 438 eyes with myopia and none had been seen in the 452 hyperopic cases. Only 6 patients had retinal detachments because four of the detachments occurred in 2 patients. Most of the wounds were small, clear corneal incisions, except for the cases where PMMA lenses were implanted.

In this study, the YAG capsulotomy rate was 40% and 4 of the 8 eyes with retinal detachments had undergone the YAG procedure prior to the retinal detachments, he noted.

Patients who had retinal detachments had axial lengths of about 26 mm although one would expect those with longer axial lengths to be at higher risk. The axial lengths in this study ranged from below 20 mm up to 33 mm, Dr. Gills noted.

Also, patients who have had a retinal detachment after clear lens replacement in one eye should be followed closely in the fellow eye because they are at risk for this complication again, he said.

"The retina should be carefully evaluated preoperatively and treated prior to clear lens replacement if the lattice looks suspicious," Dr. Gills stressed. "We are a little more aggressive now in pretreating any retinal lesions, even some holes that donít look suspicious. The patient may be predisposed to the risk."