The evaluation of the risk factors for capsular complications in phacoemulsification
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To determine and quantify the risk factors for disruption of lens capsule integrity during phacoemulsification.
The medical records of the patients who had undergone phacoemulsification cataract surgery and had a complication associated with lens capsule were reviewed. Consecutive cases were also reviewed in reverse chronological order as a control group. The exclusion criteria were pediatric cataracts, traumatic cataracts and lens dislocation. As a result, 403 uncomplicated and 83 complicated eyes were analyzed. The differences between the complication group and the group without complications regarding the risk factors were shown by employing the Chi-square test and Fischer’s exact test. The variables having the level of significance (p < 0.25) after the Chi-square test and Fischer’s exact test were enrolled into the multiple stepwise logistic regression analysis.
Age (60–69/≤80) (p = 0.017), male gender (p = 0.006), pupil size ≤3 mm (p = <0.001), mature–brunescent cataract (p = <0.001), anterior chamber depth <2.5 mm (p = 0.001), posterior polar cataract (p = 0.006), diabetic retinopathy(p = <0.001), coronary artery disease (p = 0.098) and surgeon factor (junior resident/senior resident, p = 0.015; senior resident/specialist in ophthalmology, p = 0.026; junior resident/specialist in ophthalmology, p = 0.020) were among the factors significantly related to a capsule complication. An Excel program has been developed according to these results to predict the probability of capsule complication.
Higher-risk cases can be predicted preoperatively, thus allowing surgeons to take appropriate precautions, better informing the patient and better selecting the cases especially for trainee surgeons.
KeywordsLens capsule integrity Phacoemulsification Posterior capsular rupture Risk factors
Compliance with ethical standards
Conflict of interest
Authors state that there is no conflict of interest.
- 1.Zaidi F, Corbett M, Burton B, Bloom P (2007) Raising the benchmark for the 21st century—the 1000 cataract operations audit and survey: outcomes [published ahead of print October 18, 2006]. Br J Ophthalmol 91:731–736Google Scholar
- 8.Lundstrom M, Behndig A, Kugelberg M, Montan P, Stenevi U, Thorburn W (2011) Decreasing rate of capsule complications in cataract surgery: eight-year study of incidence, risk factors, and data validity by the Swedish National Cataract Register. J Cataract Refract Surg 37:1762–1767CrossRefPubMedCentralGoogle Scholar
- 12.Artzen D, Lundstrom M, Behndig A, Stenevi U, Lydahl E, Montan P (2009) Capsule complication during cataract surgery: case-control study of preoperative and intraoperative risk factors: Swedish Capsule Rupture Study Group report 2. J Cataract Refract Surg 35:1688–1693CrossRefPubMedCentralGoogle Scholar
- 20.Uday Devgan, MD, FACS, FRCS(Glasg) (2011) Ocular Surgery News U.S. Edition, July 25Google Scholar
- 23.Squirrell D, Bhola R, Bush J, Winder S, Talbot J (2002) A prospective, case controlled study of the natural history of diabetic retinopathy and maculopathy after uncomplicated phacoemulsification cataract surgery in patients with type 2 diabetes. Br J Ophthalmol 86:565–571CrossRefPubMedCentralGoogle Scholar