Şule Berk Ergun1, Sücattin İlker Kocamış2,3, Hasan Basri Çakmak4, Nurullah Çağıl5. 1. Department of Ophthalmology, Numune Training and Research Hospital, Ankara, Turkey. 2. Department of Ophthalmology, Faculty of Medicine, Hitit University, Çorum, Turkey. drilkerkocamis@gmail.com. 3. Bahçelievler Mah. Melikgazi Cad, Şanal Apt No:2/4, Çorum, Turkey. drilkerkocamis@gmail.com. 4. Department of Ophthalmology, Faculty of Medicine, Hitit University, Çorum, Turkey. 5. Department of Ophthalmology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey.
Abstract
PURPOSE: To determine and quantify the risk factors for disruption of lens capsule integrity during phacoemulsification. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
PURPOSE: To determine and quantify the risk factors for disruption of lens capsule integrity during phacoemulsification. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: J Bradley Randleman; Jeremy D Wolfe; Maria Woodward; Michael J Lynn; D Hunter Cherwek; Sunil K Srivastava Journal: Arch Ophthalmol Date: 2007-09