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Complication rate of posterior capsule rupture with vitreous loss during phacoemulsification at a Hawaiian cataract surgical center: a clinical audit.

Chen M, Lamattina KC, Patrianakos T, Dwarakanathan S - Clin Ophthalmol (2014)

Bottom Line: Miosis, shallow chamber, restlessness, pseudoexfoliation syndrome, floppy iris syndrome, and zonulopathy were the main causes.In addition, surgeon volume (number of cases) was inversely correlated with PCR.However, there was no compatible study available for comparison, as existing studies performed at academic centers included resident cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of Ophthalmology, University of Hawaii, Honolulu, HI, USA.

ABSTRACT

Purpose: To compare the complication rate of posterior capsule rupture (PCR) with vitreous loss during phacoemulsification at an ambulatory surgical center with published results as a clinical audit for quality control.

Methods: A retrospective chart review of 3,339 consecutive patients who underwent routine phacoemulsification by four experienced private practice surgeons from January 1, 2011 to June 30, 2012 at The Surgical Suites, Honolulu, HI, USA. All cases with PCR and vitreous loss were identified and selected for the study. Risk factors of this complication were further examined. Data were sent to John H Stroger Jr Hospital of Cook County, Division of Ophthalmology, for literature review, analysis, and write-up.

Results: Twenty-three of the 3,339 cases incurred PCR and vitreous loss during phacoemulsification, for an incidence rate of 0.68%. Miosis, shallow chamber, restlessness, pseudoexfoliation syndrome, floppy iris syndrome, and zonulopathy were the main causes. In addition, surgeon volume (number of cases) was inversely correlated with PCR.

Conclusion: The rate of PCR with vitreous loss during phacoemulsification in this study may be lower than other published results done at academic centers. However, there was no compatible study available for comparison, as existing studies performed at academic centers included resident cases. This study identified risk factors for PCR/vitreous loss both preoperatively and postoperatively that may assist in application of preventive measures to decrease rates of PCR/vitreous loss.

No MeSH data available.


Related in: MedlinePlus

The rate of PCR with vitreous loss in our center versus that in academic centers.Abbreviation: PCR, posterior capsule rupture.
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f1-opth-8-375: The rate of PCR with vitreous loss in our center versus that in academic centers.Abbreviation: PCR, posterior capsule rupture.

Mentions: Mishra4 demonstrated a rate of PCR requiring anterior vitrectomy of 3.8% in 7,008 cases, of which 14%–15% of surgeries were performed by residents. Pingree et al5 reported 44 cases of PCR in 1,729 cataract surgeries (2.54%), with 29 (1.68%) requiring anterior vitrectomy over an 18-month period. A clinical audit performed by Chan et al6 out of Singapore in 2003 showed that PCR occurred in 155 of 8,230 consecutive eyes (1.9%) that had extracapsular cataract extraction or phacoemulsification; of those, 91 eyes (1.1%) had concurrent vitreous loss. A 2006 study from the United Kingdom showed that over a 2-year period, 2,727 cataract extractions were performed with a PCR rate of 1.7% and a vitreous loss rate of 1.0%.7 A prospective study conducted in Australia demonstrated a rate of posterior capsule tears with vitreous loss of 1.4% in 1,000 cases.8 Surgeons at the Leicester Royal Infirmary performed a total of 2,538 phacoemulsification cataract extractions, 92 (3.6%) of which required anterior vitrectomy for PCR.9 Corey and Olson10 conducted a resident performance study out of Salt Lake City, Utah that showed a vitreous loss rate of 1.8% in 396 cases (Figures 1–3).


Complication rate of posterior capsule rupture with vitreous loss during phacoemulsification at a Hawaiian cataract surgical center: a clinical audit.

Chen M, Lamattina KC, Patrianakos T, Dwarakanathan S - Clin Ophthalmol (2014)

The rate of PCR with vitreous loss in our center versus that in academic centers.Abbreviation: PCR, posterior capsule rupture.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921080&req=5

f1-opth-8-375: The rate of PCR with vitreous loss in our center versus that in academic centers.Abbreviation: PCR, posterior capsule rupture.
Mentions: Mishra4 demonstrated a rate of PCR requiring anterior vitrectomy of 3.8% in 7,008 cases, of which 14%–15% of surgeries were performed by residents. Pingree et al5 reported 44 cases of PCR in 1,729 cataract surgeries (2.54%), with 29 (1.68%) requiring anterior vitrectomy over an 18-month period. A clinical audit performed by Chan et al6 out of Singapore in 2003 showed that PCR occurred in 155 of 8,230 consecutive eyes (1.9%) that had extracapsular cataract extraction or phacoemulsification; of those, 91 eyes (1.1%) had concurrent vitreous loss. A 2006 study from the United Kingdom showed that over a 2-year period, 2,727 cataract extractions were performed with a PCR rate of 1.7% and a vitreous loss rate of 1.0%.7 A prospective study conducted in Australia demonstrated a rate of posterior capsule tears with vitreous loss of 1.4% in 1,000 cases.8 Surgeons at the Leicester Royal Infirmary performed a total of 2,538 phacoemulsification cataract extractions, 92 (3.6%) of which required anterior vitrectomy for PCR.9 Corey and Olson10 conducted a resident performance study out of Salt Lake City, Utah that showed a vitreous loss rate of 1.8% in 396 cases (Figures 1–3).

Bottom Line: Miosis, shallow chamber, restlessness, pseudoexfoliation syndrome, floppy iris syndrome, and zonulopathy were the main causes.In addition, surgeon volume (number of cases) was inversely correlated with PCR.However, there was no compatible study available for comparison, as existing studies performed at academic centers included resident cases.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Division of Ophthalmology, University of Hawaii, Honolulu, HI, USA.

ABSTRACT

Purpose: To compare the complication rate of posterior capsule rupture (PCR) with vitreous loss during phacoemulsification at an ambulatory surgical center with published results as a clinical audit for quality control.

Methods: A retrospective chart review of 3,339 consecutive patients who underwent routine phacoemulsification by four experienced private practice surgeons from January 1, 2011 to June 30, 2012 at The Surgical Suites, Honolulu, HI, USA. All cases with PCR and vitreous loss were identified and selected for the study. Risk factors of this complication were further examined. Data were sent to John H Stroger Jr Hospital of Cook County, Division of Ophthalmology, for literature review, analysis, and write-up.

Results: Twenty-three of the 3,339 cases incurred PCR and vitreous loss during phacoemulsification, for an incidence rate of 0.68%. Miosis, shallow chamber, restlessness, pseudoexfoliation syndrome, floppy iris syndrome, and zonulopathy were the main causes. In addition, surgeon volume (number of cases) was inversely correlated with PCR.

Conclusion: The rate of PCR with vitreous loss during phacoemulsification in this study may be lower than other published results done at academic centers. However, there was no compatible study available for comparison, as existing studies performed at academic centers included resident cases. This study identified risk factors for PCR/vitreous loss both preoperatively and postoperatively that may assist in application of preventive measures to decrease rates of PCR/vitreous loss.

No MeSH data available.


Related in: MedlinePlus