Changing patterns of early complications in cataract surgery with new techniques: a surgical audit

We have undertaken a retrospective review of samples of case records from patients undergoing cataract surgery at St Thomas's Hospital over the years of the introduction of new extracapsular techniques and the widespread use of intraocular lens implants. We found no significant change in the proportion of patients achieving a corrected visual acuity of better than or equal to 6/12 three months after surgery. However, the pattern of complications was found to have changed in three respects. Firstly, there was a fall in the frequency of raised intraocular pressure requiring treatment associated with the abandonment of intracapsular surgery and the use of chymotrypsin. Secondly, a considerable number of patients who had had extracapsular extractions suffered from visually disabling posterior capsular thickening (13%). Thirdly, there was a downward trend in the rates of vitreous loss and of reduced vision at three months due to vitreous haemorrhage, vitritis, and retinal detachment in the patients undergoing extracapsular cataract surgery.