Retinal Detachment (cont.)

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How does cataract surgery lead to a retinal detachment?

Cataract surgery, especially, if the operation has complications involving the vitreous, increases the risk of a retinal detachment. Cataracts create a cloudiness (opacity) within the lens. In cataract surgery today, the goal is to leave much of the capsule of the natural lens in place. Phacoemulsification, the most common procedure, utilizes a very high speed ultrasonic instrument to break up and suck out the clouded lens material inside the capsule. The new intraocular lens (IOL) is then placed within the capsule. The IOL and intact capsule help to support the vitreous gel which fills the back of the eye. Movement of the vitreous gel is a key factor in retinal detachments because the vitreous movement can place traction on the retina and lead to a hole or tear which can be the start of a detachment. Although cataract surgery does increase the chance of retinal detachment, the risk is low, that is less than 2 % over 20 years; and the benefits of cataract surgery ordinarily far outweigh the risk of retinal detachment.

What other factors are associated with a retinal detachment?

  • Blunt trauma, as from a tennis ball or fist, or a penetrating injury by a sharp object to the eye can lead to a retinal detachment.
  • A family history of a detached retina that is non-traumatic in nature seems to indicate a genetic (inherited) tendency for developing retinal detachments.
  • In a few patients with a non-traumatic retinal detachment of one eye, a detachment subsequently occurs in the other eye. Accordingly, the second eye of a patient with a retinal detachment must be examined thoroughly and followed closely, both by the patient and the ophthalmologist.
  • Diabetes can lead to a type of retinal detachment that is caused by pulling on the retina (traction) alone, without a tear. Because of abnormal blood vessels and scar tissue on the retinal surface in some people with diabetes, the retina can be lifted off (detached) from the back of the eye. In addition, the blood vessels may bleed into the vitreous gel. This detachment may involve either the periphery or central area of the retina.
Medically Reviewed by a Doctor on 1/22/2014

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