Factors Associated with Retinal Detachment after Pediatric Cataract Surgery in the IRIS® Registry

Abstract

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.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.