Risk factors for dropped nucleus in cataract surgery as reflected by the European Registry of Quality Outcomes for...

To analyze the incidence, risk factors, and outcomes of cataract surgery complicated by a dropped nucleus.

Patients who have received cataract surgery in 18 European countries.

Retrospective cross-sectional register-based study.

Data from the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) were analyzed. The EUREQUO contains preoperative baseline, intraoperative, and follow-up data. Intraoperative data include dropped nucleus as a complication. Baseline data such as demographic data, ocular comorbidities, surgical difficulties, and visual and refractive outcomes were tested for association with a dropped nucleus for the study period from January 1, 2008, to December 31, 2018.

The number of reported patients with complete data was 1 715 348. Dropped nucleus was reported in 1221 eyes (0.071%) during the study period. White cataract, previous vitrectomy, poor preoperative visual acuity, small pupil, pseudoexfoliation, diabetic retinopathy, and male sex were significantly related to dropped nucleus. Year of surgery showed a significant trend of decreasing occurrence of dropped nucleus over time. Eyes with the complication of a dropped nucleus also had a poorer visual and refractive outcome compared with eyes with existing risk factors but no such complication.

Many risk factors for dropped nucleus complications were identified. A significant trend of decreasing occurrence of dropped nucleus was found for the study period. The visual and refractive outcome was poorer for eyes with a dropped nucleus.