PubMed ID: 40081617
Author(s): Altamirano F, Jeon JH, Lee JY, Elze T, Miller JW, Lorch AC, VanderVeen DK, Gonzalez E, Oke I; IRIS® Registry Analytic Center Consortium. Factors Associated with Retinal Detachment after Pediatric Cataract Surgery in the IRIS® Registry. Ophthalmology. 2025 Aug;132(8):888-894. doi: 10.1016/j.ophtha.2025.03.003. Epub 2025 Mar 11. PMID: 40081617; PMCID: PMC12277073.PMID 40081617
Journal: Ophthalmology 132(8)
Purpose: This study leverages the American Academy of Ophthalmology’s IRIS® Registry (Intelligent Research in Sight) to identify factors associated with retinal detachment (RD) after pediatric cataract surgery.
Design: Retrospective cohort study.
Participants: All children (age < 18 years) who underwent cataract surgery between January 2013 and December 2020 at practices that participate in the IRIS Registry.
Methods: Data collected included patient demographics and medical history. Current Procedural Terminology codes were used to identify procedures for cataract surgery and RD repair. International Classification of Disease codes were used to classify diagnoses such as degenerative high myopia, persistent fetal vasculature, retinopathy of prematurity, ocular trauma, and retinal detachment. The Kaplan-Meier estimator was used to determine the cumulative incidence of retinal detachment diagnosis and repair after cataract surgery. Hazard ratios with 95% confidence intervals were calculated using multivariable Cox regression models.
Main outcome measures: Cumulative incidence of RD diagnosis and repair within 5 years of cataract surgery.
Results: Seven thousand four hundred seven children (53% male, 49% White non-Hispanic) were identified and included. The cumulative incidence of retinal detachment diagnosis and repair after cataract surgery was 3.8% (95% CI, 3.1%-4.5%) and 1.6% (95% CI, 1.2%-2.0%), respectively. Children with a history of ocular trauma (hazard ratio [HR], 2.22; 95% CI 1.39-3.57; P < 0.001), aphakia (HR, 2.10; 95% CI, 1.43-3.10; P < 0.001), premature retina (HR 2.73; 95% CI, 1.36-5.48; P = 0.005), persistent fetal vasculature (HR, 3.26; 95% CI, 1.58-6.71; P = 0.001), and Hispanic ethnicity (HR, 1.71; 95% CI, 1.15-2.54; P = 0.008) were at increased risk of RD diagnosis within 5 years of cataract surgery. Similar risk factors were identified for RD requiring surgical repair.
Conclusions: Among children undergoing cataract surgery in the IRIS Registry, RD was associated with a history of ocular trauma, aphakia, premature retina, persistent fetal vasculature, and Hispanic ethnicity. Identifying risk factors for complications after cataract surgery is essential to guide preoperative decision-making and long-term monitoring to mitigate RD risk in vulnerable patients.