Visual outcome in cataract surgery complicated by vitreous loss in a district general hospital

To determine the visual outcome of patients following cataract surgery complicated by vitreous loss and to establish the factors, if any, that influenced the final visual outcome.

Retrospective review of all patients over a 1-year period who had planned phacoemulsification complicated by vitreous loss. Information was entered into a pre-devised proforma and the results analysed.

Of the 1614 eyes operated on for cataract, 43 (2.66%) had surgery complicated by vitreous loss. The mean age of the patients experiencing surgical complications was 79.7 years (range 48-93 years). Twenty-three patients (53%) had at least one factor contributing to the difficulty of procedure, with dense cataract being the top factor in 11 patients. There was no statistically significant association between any pre-operative predisposing factor, stage at which vitreous loss occurred, grade of the surgeon and final visual outcome. When pre-existing co-morbidity was excluded, 26 of 30 (87%) patients achieved a best-corrected visual acuity of 6/12 or better post-operatively. Cystoid macula oedema was the underlying cause in 50% of those patients that lost one or more lines post-operatively.

Surgeons at all levels of training had an acceptable complication rate, with the majority of patients achieving a good visual outcome. Dense cataract was the most common factor contributing to the complexity of the surgery.