Capsule complication during cataract surgery: Case-control study of preoperative and intraoperative risk factors: Swedish Capsule Rupture Study Group report 2
Received 13 March 2009; received in revised form 12 May 2009; accepted 12 May 2009.
Purpose
To identify preoperative and intraoperative factors associated with a capsule complication; that is, a capsule tear or a zonular dehiscence during cataract surgery.
Setting
Ten ophthalmic surgery departments in Sweden.
Methods
A retrospective review of files of patients with a capsule complication and control patients with no complication operated on in 2003 was performed.
Results
The review comprised 324 patients with a capsule complication and 331 control patients. In the logistic regression analyses, preoperative conditions associated with a capsule complication were previous trauma, white and brunescent/hard cataract, and phacodonesis. The intraoperative factors of loose zonules, the use of trypan blue, and miosis were all statistically significantly overrepresented in the capsule complication group. The same was true for eyes operated on by surgeons with the least experience.
Conclusions
By preoperatively identifying cataract cases with the identified risk factors and allocating them to surgeons with the longest experience, the number of capsule complications could be kept low. Operating early in the course of the disease to prevent the cataract from becoming a poor surgical risk and improving training of junior surgeons should further reduce the frequency of capsule complications.
From St. Erik Eye Hospital (Artzén, Montan), Stockholm, EyeNet Sweden (Lundström), Blekinge Hospital, Karlskrona, and the Departments of Ophthalmology Umeå University Hospital (Behndig), Umeå, Sahlgrenska University Hospital (Stenevi), Mölndal, and Lake Mälare Hospital (Lydahl), Eskilstuna, Sweden
No author has a financial or proprietary interest in any material or method mentioned.
Supported by grants from Synfrämjandets Forskningsfond and the Hubacz Foundation, Stockholm, Sweden.
Presented in part at the ASCRS Symposium on Cataract, IOL and Refractive Surgery, San Diego, California, USA, April 2007, and the XXV Congress of the European Society of Cataract & Refractive Surgeons, Stockholm, Sweden, September 2007.
ABSTRACT