To establish a risk prediction model for secondary cataract within 2y after pars plana vitrectomy (PPV) in patients with primary rhegmatogenous retinal detachment (RRD).

Clinical data of patients with primary RRD treated at the Shenzhen Eye Hospital were retrospectively collected. Twenty-four potential influencing factors, including patient characteristics and surgical factors, were selected for analysis. Independent risk factors for secondary cataract were identified through univariate comparisons and multivariate logistic regression analysis. A risk prediction model was constructed and evaluated using receiver operating characteristic (ROC) curves, area under the ROC curve (AUC), calibration plots, and decision curve analysis (DCA) curves.

The 386 cases (389 eyes) of patients who underwent PPV and had complete surgical records were ultimately included. Within a 2-year longitudinal observation, 41.39% of patients developed cataract secondary to PPV. Logistic regression results identified a history of hypertension [odds ratio (OR)=1.78, 95%CI: 1.002–3.163, P=0.049], silicone oil tamponade (OR=3.667, 95%CI: 2.373–5.667, P=0.000), and lens thickness (OR=1.978, 95%CI: 1.129–3.464, P=0.017) as independent risk factors for cataract secondary to PPV. The constructed nomogram achieved AUC=0.6974. Calibration plots indicated good agreement between predicted and observed outcomes, while DCA curves demonstrated the model’s clinical utility.

By incorporating a history of hypertension, vitreous substitute type, and lens thickness, this study constructs a prediction model with moderate discriminative ability. This model offers a valuable tool for clinicians to identify high-risk patients early, potentially allowing for more timely interventions and improved patient outcomes.