Intraoperative complications during cataract surgery in the very old

Area of Science:

• Ophthalmology
• Geriatric Medicine
• Surgical Outcomes

Background:

• Cataract surgery is a common procedure, but patient age may influence surgical outcomes.
• The safety and efficacy of cataract surgery in the very elderly population require specific investigation.

Purpose of the Study:

• To compare the incidence of intraoperative complications during cataract surgery between very old patients (>= 88 years) and younger patients (< 88 years).

Main Methods:

• Retrospective review of 802 consecutive cataract surgeries using small-incision phacoemulsification.
• Comparison of intraoperative complication rates between a "very old" group (102 eyes, 88-98 years) and a "younger" group (700 eyes, < 88 years).

Main Results:

• The very old group experienced a higher overall complication rate (10% vs. 3%) including posterior capsule tears and vitreous loss (7% vs. 1.6%).
• Complicated cases in the very old had significantly worse visual acuity outcomes (40% achieving 20/40 vs. 90.5% in younger patients).
• Pupil stretching was more frequent in the very old (8% vs. 2%).

Conclusions:

• Very old patients (>= 88 years) exhibit a higher risk of intraoperative complications during cataract surgery.
• These complications can lead to significant and potentially severe visual impairment in the elderly.
• Findings underscore the importance of considering age-related risks in cataract surgery planning and management.