Risk factors for vitreous loss in cataract surgery

To evaluate the risk factors for posterior capsule rupture with or without vitreous loss (PCR +/- VL) in extracapsular cataract extraction (ECCE).

The charts of 2794 consecutive patients who had ECCE with or without intraocular lens implantation between January 1992 and December 1997 were reviewed retrospectively. Probable risk factors included age, sex, operated eye (right or left), presence of diabetes mellitus, systemic hypertension, history of vitreous loss in the other eye (if operated), type of cataract, axial length of the eye, preoperative visual acuity, glaucoma, presence of pseudoexfoliation, preoperative shallow anterior chamber and experience of surgeon (resident, general ophthalmologist, cataract surgeon). We compared 192 patients who had PCR +/- VL with complete data and 275 randomly selected patients who had no complications, using multiple logistic regression analysis.

Two hundred and fifty-four patients (9.09%) had PCR and 197 (7.05%) had PCR + VL. The surgeon's experience (p < 0.0005), glaucoma (p < 0.005), type of cataract (p < 0.005), presence of pseudoexfoliation (p < 0.05) and systemic hypertension (p < 0.05) were significant risk factors.

Patients with risk factors such as glaucoma, pseudoexfoliation, traumatic cataract and systemic hypertension should be operated by experienced surgeons.