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Thursday, January 14, 2010

Male Myopes HIgher Retinal Detachment Risk

TOP STORIES 1/13/2010Younger male myopes have higher retinal detachment risk 4 years after cataract surgeryAm J Ophthalmol. 2009;149(1):113-119.
Younger age, male gender and increased axial length were associated with an elevated risk of retinal detachment 4 years after cataract removal and IOL implantation, according to a study.
Myopic eyes are especially prone to various ocular pathologies and postoperative complications. The prevalence of myopia among young people has increased to about 10% to 25% in Western nations and 60% to 80% in Eastern nations, the study authors said.
"Inasmuch as the World Health Organization reports myopia as the leading cause of visual impairment, myopia-related complications remain an important concern for ophthalmologists," they said. "Myopia is a proven significant risk factor for [retinal detachment] after cataract extraction."
The prospective cohort study included 9,388 patients who underwent extracapsular cataract extraction with phacoemulsification and IOL implantation in Taiwan between August 1999 and December 2001. Mean patient age was 65.96 years. Mean follow-up was 79.21 months.
Axial length was less than 23 mm in 4,445 eyes (47.34%), 23 mm to 26 mm in 4,394 eyes (46.8%), and 26 mm or more in 549 eyes (5.85%).
Study data showed an overall cumulative 8-year retinal detachment rate of 2.31%. The mean length of time between cataract removal and retinal detachment diagnosis was 40.6 months. Male gender, age younger than 50 years, history of retinal detachment in the contralateral eye and phacoemulsification correlated with retinal detachment risk; the associations were statistically significant (P = .01, P = .002, P = .005 and P = .013, respectively).
In addition, eyes with axial length of more than 26 mm had a significantly higher risk of pseudophakic retinal detachment than eyes with axial length of 23 mm to 26 mm (P = .0003). A late increase in the risk of retinal detachment was highest among male patients with high myopia.
"Although we did not have data about the characteristics of [retinal detachment] in our study, we speculate that anomalous posterior vitreous detachment developed years after cataract extraction and caused the late wave of increased risk for pseudophakic [retinal detachment] in our results," the authors wrote. "However, this speculation could not explain the lack of late increase in females."
Patient education and prophylactic treatment are critical for managing risk factors, they said.

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