Incidence and risk factors for retinal detachment following implantation with a multifocal or EDOF IOL: A 15-year follow-up.

Purpose: To determine the incidence and risk factors for retinal detachment following multifocal IOL implantation, and to assess its management.

Setting: Ophthalmology Department, Morvan Hospital, University Hospital of Brest, France.

Design: Retrospective cohort.

Methods: We retrospectively reviewed eyes that had undergone refractive cataract surgery (multifocal or EDOF IOL) from January 2006 to July 2023 at Brest University Hospital. An analytical study was carried out to identify factors influencing the occurrence of retinal detachment (RD). Hazard ratios were calculated using the Cox model.

Results: Of the 1682 eyes followed for 6 to 207 months, 26 RDs occurred, i.e., 1.55%. The<55-year-old population with an axial length (AL)>25mm was at greater risk of RD, with HRs of 5.13 (95% CI, 1.07-24.52) and 6.05 (95% CI, 1.36-27.61) respectively. Similarly, posterior capsular rupture increased the risk, with a HR of 9.96 (95% CI, 3.70-26.82). No explantation was required after the retinal detachment surgery.

Conclusion: Cataract surgery has now become refractive surgery, with the goal of spectacle independence. We show that eyes of young, highly myopic, presbyopic patients are exposed to a greater risk of retinal detachment, and we identify two considerations that should be included in patient selection: axial length>25mm and age<55 years.