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Volume 35, Issue 10, Pages 1679-1687.e1 (October 2009)


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Capsule complication during cataract surgery: Background, study design, and required additional care: Swedish Capsule Rupture Study Group report 1

Mats Lundström, MD, PhDCorresponding Author Informationemail address, Anders Behndig, MD, PhD, Per Montan, MD, PhD, Ditte Artzén, MD, Gunnar Jakobsson, MD, Björn Johansson, MD, PhD, William Thorburn, MD, PhD, Ulf Stenevi, MD, PhD

Received 13 March 2009; received in revised form 12 May 2009; accepted 12 May 2009.

Purpose

To report the selection procedure of complicated and uneventful cataract extractions included in the Swedish Capsule Rupture Study and to describe the additional care required after a capsule complication during cataract surgery.

Setting

Ten ophthalmic surgery departments in Sweden.

Methods

Consecutive cataract extractions with a reported capsule complication were selected from the national database. Surgical data and data from the matching ophthalmic records at the participating clinics were analyzed. Controls were selected as the first uneventful procedure in the database after each procedure with a complication.

Results

Data on 655 cataract extractions were studied for evaluation of risks and additional care; a capsule complication occurred in 324 procedures and no complication in 331 procedures. Using these records, 369 patients were recruited for a follow-up examination of the outcomes 3 years after the original cataract extraction. The records showed a substantial increase in additional care after a capsule complication, including more visits after surgery, increased need for in-patient care, and a significantly greater percentage of reoperations than after the uneventful surgery. With additional care, the average cost of a procedure with a capsule complication was approximately double the cost of an uneventful cataract extraction.

Conclusions

The combined study of the database and matching medical records showed a substantial increase in additional care after a capsule complication. Using the database allowed identification of a large number of capsule complication cases and uneventful cases, indicating that national databases are excellent sources of data for studying unusual complications.

From EyeNet Sweden (Lundström), Blekinge Hospital, Karlskrona, the Department of Clinical Sciences/Ophthalmology (Behndig, Thorburn), Umeå University Hospital, Umeå, St. Erik Eye Hospital (Montan, Artzén), Stockholm, the Departments of Ophthalmology, Sahlgren's University Hospital (Jakobsson, Stenevi), Mölndal, and Linköping University Hospital (Johansson), Linköping, Sweden

Corresponding Author InformationCorresponding author: Mats Lundström, MD, PhD, EyeNet Sweden, Blekinge Hospital, SE-371 85 Karlskrona, Sweden.

 No author has a financial or proprietary interest in any material or method mentioned.

 Supported by the Swedish Association of Local Authorities and Regions and the Swedish National Board of Health and Welfare.

PII: S0886-3350(09)00654-3

doi:10.1016/j.jcrs.2009.05.025


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