AIM: To study the prevalence of complications of cataract surgery and any association between the occurrence of complications and experience of surgeon, type of surgery, type of anaesthesia and visual outcome.
METHODS: This was a retrospective study of patients who underwent cataract surgery over a period of two years in a district hospital in Malaysia. The demographic details of patients, type of surgery done, as well as type of anaesthesia used and experience of the surgeon were noted. The types of intraoperative and postoperative complications were recorded. The final best corrected visual outcome was recorded.
RESULTS: Complications occurred in 11.1% of the total 1007 patients operated. Posterior capsule rupture (3.6%) was the most common complication. The experience of the surgeon and the type of anaesthesia used did not affect complications during surgery. Intracapsular cataract extraction (ICCE) and phacoemulsification converted to extracapsular cataract extraction (ECCE) were significantly associated with more complications (P<0.001). The visual outcome was significantly poor in patients with complications (P<0.001).
CONCLUSION: The occurrence of complications during cataract surgery significantly affected the visual outcome. The type of surgery done was associated by the occurrence of complications. However, the experience of the surgeon and the type of anaesthesia used did not affect the occurrence of complications. We recommend that particular attention be given to ICCE and phacoemulsification converted to ECCE to minimise the complications and thereby reducing the chances of poor vision postoperatively.
AIM: To see the causative factors, associations and outcomes of posterior capsule rupture (PCR). METHODS: A retrospective cohort study was done of all patients with PCR from 2007 to 2014 in Melaka Hospital. Associations between ocular comorbidities, lens related complications, surgeon grade, type of cataract surgery, whether done alone or in combination, with the occurrences of PCR were studied. The final visual outcome of cases with PCR was studied. RESULTS: PCR was the commonest intraoperative complication (n=623, 4.8%) among 12 846 patients. Ocular comorbidities and status of the lens did not cause PCR. Experience and seniority of surgeons were significantly associated with PCR. Medical officers had more PCRs than gazetting specialists (P=0.0000), who inturn had more PCRs than specialists (P=0.000). Each type of cataract surgery done was also significantly associated with PCR-phacoemulsification (phaco), phaco convert to extracapsular cataract extraction (ECCE) and intracapsular cataract extraction (ICCE) (P=0.000), lens aspiration (P=0.020), and ECCE (P=0.003). Specialists got good outcomes compared to trainees without PCR occurring (P=0.001) and also with PCR occurring (P=0.013). However, no difference was observed in the occurrence of PCR in complicated cases between specialists and trainees. Vision was compromised mainly by astigmatism following PCR. Impaired vision (P=0.000) and poor vision (P=0.000) were more than good vision. Poor vision was more in PCR compared to other complications.(P=0.000). CONCLUSION: PCR occurs in all types of cataract surgeries and is the main intraoperative complication causing poor vision. Good outcomes were significantly more when specialists got PCR compared to trainees. Junior surgeons should practice in wet labs and be given more cases. Copyright 2016 by the IJO Press.