Visual Acuity Prior to Cataract Surgery and Risk of Retinal Detachment-A Population-Based Study

Purpose: To analyze preoperative visual acuity before cataract surgery regarding the risk of rhegmatogenous retinal detachment (RRD) after cataract surgery. Methods: The preoperative visual acuity in an observational cohort study of patients undergoing cataract surgery in Skane, southern Sweden, during 2015-2017 was analyzed with data retrieved from the Swedish National Cataract Register. This was then cross-referenced with patients undergoing surgery for retinal detachment at the Skane University Hospital in Lund from 2015 to 2020. The main outcome was the risk-benefit ratio of measuring preoperative visual acuity before cataract surgery and the risk of RRD. Results: The mean visual acuity in the whole study group (N=58,624), expressed as LogMAR, was 0.40 & PLUSMN; 0.32 (SD). In the group with RRD (n=298), the mean visual acuity was 0.44 & PLUSMN; 0.36 (p=0.07). In the subgroups of RRD, those aged <60 years 0.49 & PLUSMN; 0.44 (p=0.07), aged <60 years and axial length (AL) >25 mm 0.42 & PLUSMN; 0.38 (p=0.68), and in those aged <60 years, AL >25 mm and male sex 0.44 & PLUSMN; 0.39 (p=0.53). However, there is considerable variations in visual acuity of the various groups and in the high-risk group with RRD aged <60 years with AL>25 mm, 15% had a visual acuity of 0.8 or better in the operated eye. Conclusion: There must be strong indications for performing cataract surgery in those with a high risk of retinal detachment, and the patient must be given adequate information on the risk of retinal detachment.