[Pseudophakic retinal detachment in relation to complications of cataract surgery]

The authors made a retrospective study in a group of 14 patients operated in 1999 on account of pseudophakic detachment of the retina (D.R.). They followed up risk factors of development of D.R. in conjunction with complications of cataract surgery. The investigated factors comprised patients sex and age, type of cataract operation and type of implanted lens, complications of cataract surgery, time interval between cataract surgery and the development of D.R., pre-operative and postoperative visual acuity and type of operation of D.R. In the group there was a significant ratio of men (71.4%), the mean age was 60.28 years and 78.6% of the patients were referred to our department. Phaćoemulsification with implantation of IOL was made in 57% of the patients, extracapsular extraction with implantation of IOL in 47%. The authors did not find a significant difference between the type of cataract surgery with regard to the development of D.R. A posterior chamber intraocular lens was implanted in 71% eyes of the group while an anterior chamber intraocular lens was used only in 29% of the eyes in the group. Complications of cataract surgery were above all ruptures of the posterior capsule (64%). Dislocation of the lens into the vitreous body during surgery was recorded only in one case (7%) a non-complicated operation of cataract was recorded in 28%, incl. one case (7%) where D.R. was preceded by laser capsulotomy. The mean time interval between cataract operation and D.R. was 20.7 months. The visual acuity before surgery of D.R. was 0.24 while after surgery it was 0.31. In 50% patients a cryosurgical procedure was used in operation of D.R., pars plana vitrectomy as the first operation of D.R. was used in 50% of the group. Adherence of the retina after the first operation was achieved in 64.2% eyes, after re-operation in 85.7% eyes. The authors did not find a significant difference between the type of cataract surgery and type of implanted lens as regards anatomical and functional results of surgery of D.R. Proliferative vitreoretinopathy and dysfunction of the photoreceptors were the main cause of anatomical and functional failure the operation of D.R. in the group. The number of pseudophacic D.R. after laser capsulotomy did not exceed the number of D.R. after non-complicated cataract surgery in the investigated group.