We aimed to evaluate the rate and determinants of reoperation after age-related cataract surgery and its potential risk factors.

 In this retrospective case-cohort study conducted at a tertiary eye hospital, Tehran, Iran, a representative sample of patients with cataract surgery from March 2017 to March 2021 was randomly selected from the hospital's medical records and reviewed for returns to the operating room during the first year after the procedure. Demographics, ocular characteristics, and operative factors of patients with reoperation were reviewed, and 3 randomly selected patients with a history of the same-day surgery for each reoperation case were designated as the controls. Potential risk factors were compared using multivariable logistic regression.

 Among the included 4666 surgery records, 70 reoperations related to 63 eyes (1.52%) were detected, with the reoperation rates of 0.75% for attendings and fellowship surgeons, and 3.57% for residents in training. Aphakia (20.0%), endophthalmitis (15.7%), and rhegmatogenous retinal detachment (14.3%) were the most common reasons for reoperations. After adjusting for potential confounders among the 70 reoperations and 211 controls, posterior capsular rupture (PCR), blepharitis and/or meibomian gland dysfunction (MGD), and axial length < 22.0 or > 24.5mm were significantly associated with reoperation.