Intraoperative complications of phacoemulsification in eyes with and without pseudoexfoliation.
ABSTRACT To determine the intraoperative complications in a large series of phacoemulsification procedures, including patients with and without pseudoexfoliation, excluding those with marked phacodonesis or lens subluxation.
Department of Ophthalmology, Carmel Medical Centre, Haifa, Israel.
This institutional case-control study included 1501 consecutive phacoemulsification procedures: 137 eyes with pseudoexfoliation and 1364 eyes without this condition. Baseline demographics and clinical factors were collected from the medical files. A comparative analysis of the incidence of intraoperative complications in eyes with or without pseudoexfoliation was calculated. Univariate analysis and multiple logistic regression were used to identify ocular factors that predicted intraoperative complications.
There was no significant difference (P>.05) in the rate of intraoperative complications between the pseudoexfoliation (5.8%) and control (4.0%) groups. There were no significant differences in the incidence of capsular breaks, vitreous loss, and zonular ruptures without vitreous loss in the 2 groups. Pseudoexfoliation did not confer a statistically higher risk for intraoperative complications (odds ratio 1.62, 95% confidence interval 0.74-3.55).
Phacoemulsification by experienced surgeons is safe in eyes with pseudoexfoliation without marked phacodonesis or lens subluxation.
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ABSTRACT: To analyze the rate of intraoperative complications, reoperations, and endophthalmitis with phacoemulsification, manual small-incision cataract surgery (SICS), and large-incision extracapsular cataract extraction (ECCE). Aravind Eye Hospital, Madurai, India. Retrospective cohort study. This study comprised consecutive cataract surgeries performed during a 12-month period. All surgical complications and endophthalmitis cases were tabulated and analyzed for each of 4 surgeon groups (staff, fellows, residents, visiting trainees). Within each surgeon group, complication rates with phacoemulsification, manual SICS, and ECCE were compared. The surgical distribution was 20,438 (26%) phacoemulsification, 53,603 (67%) manual SICS, and 5736 (7%) ECCE. The overall intraoperative complication rate was 0.79% for staff, 1.19% for fellows, 2.06% for residents, and 5% for visiting trainees. Extracapsular cataract extraction had the highest overall rate of surgical complications (2.6%). The overall complication rate was 1.01% for manual SICS and 1.11% for phacoemulsification. However, the combined complication rate for trainees was significantly higher with phacoemulsification (4.8%) than with manual SICS (1.46%) (P<.001). The corrected distance visual acuity was better than 6/12 in 96% after phacoemulsification complications and 89% after manual SICS complications (P<.001). There were 27 cases (0.04%) of endophthalmitis but no statistical differences between surgical methods or surgeon groups. For staff surgeons experienced with both phacoemulsification and manual SICS, intraoperative complication rates were comparably low. However, for trainee surgeons, the complication rate was significantly higher with phacoemulsification, suggesting that manual SICS may be a safer initial procedure to learn for inexperienced cataract surgeons in the developing world. No author has a financial or proprietary interest in any material or method mentioned.Journal of Cataract and Refractive Surgery 08/2012; 38(8):1360-9. · 2.75 Impact Factor
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ABSTRACT: Purpose: To evaluate the incidence of pseudoexfoliation syndrome (XFS) in patients with senile cataract who were scheduled for phacoemulsification and intraocular lens implantation (PE + IOL) and to compare the outcomes of PE+IOL between eyes with and without XFS. Method: We retrospectively reviewed 2200 eyes with cataract undergoing PE + IOL. All procedures were performed by a single surgeon (M.A.J) at a private clinic. Patients with XFS were considered as the case group and age and sex matched patients without XFS were selected as controls. Results: The incidence of XFS was 4.1% (90 eyes). Mean age was 71.8±7.1 and 70.7±6.7 years in the case and control groups, respectively. XFS was unilateral in 60% of the cases. The prevalence of hypertension, diabetes mellitus (DM) and diabetic retinopathy (DR) was 31.1%, 6.7% and 0% in the XFS group vs 42.9%, 26.6% and 5.2% in the control group, respectively (P< 0.05). Glaucoma was present in 25.6% of the XFS group and 6.5% of the control group (P<0.0001). Vitreous loss occurred in one eye in each group; only one eye had zonular dehiscence in the XFS group. Iris stretching was performed during surgery in 11.1% in the XFS group and 1.9% in the control group (P<0.0001). Anterior capsule contraction occurred in 9.1% of the XFS group vs 0% in the control group (P= 0.007). Conclusion: PE + IOL in patients with XFS is as safe and effective as pure senile cataract. The incidence of DM and DR is significantly lower in XFS. • Bina J Ophthalmol 2006; 12 (1): 37-43.01/2006;
- Journal francais d'ophtalmologie 04/2014; · 0.51 Impact Factor