Popular lens surgeries carry retinal detachment risks

Lens replacement surgeries, increasingly marketed to people in their 40s and 50s, raise the risk of retinal detachment—especially in younger patients—according to a report by Finnish public broadcaster Yle.

If left untreated for even a few days, detachment can permanently impair vision or cause blindness.

Kaj Holmbäck, 59, from Kokkola, noticed a dark area spreading across his right eye’s field of vision last December. After three prior eye surgeries, his vision was already poor. Four days later, doctors diagnosed a retinal detachment. Emergency surgery could not restore his previous eyesight.

At Helsinki University Hospital (HUS), urgent retinal detachment repairs have surged in recent years, said Petri Aaltonen, head of vitreoretinal surgery. Weekend cases are now centralized at HUS nationwide.

Two years ago, such surgeries had already risen 60% over a decade, a trend Aaltonen believes has continued. Aging populations and more cataract surgeries explain part of the increase, but so do elective lens replacements for presbyopia in middle age.

Risk factors include severe myopia, prior cataract or lens surgery—particularly at a younger age—and male sex. Aaltonen cited European studies suggesting a strong link between lens surgery and detachment, though absolute proof remains elusive.

In northern Finland, a study of cases treated by the North Ostrobothnia wellbeing services district shows a marked rise in post-cataract detachments since the early 2020s, possibly tied to the growing popularity of presbyopia-correcting lens surgeries.

At Silmäasema, Finland’s largest private provider of lens surgeries with about 4,000 procedures annually, medical director Kaisu Järvinen called the detachment risk “very small—on the order of a few percent.” She said high-risk patients are identified and counseled before surgery.

Symptoms of retinal detachment include a spreading shadow at the edge of vision, flashes of light, or floating specks. Immediate treatment is critical to prevent permanent vision loss.