Risk factors for intraoperative complications in 1000 extracapsular cataract cases

A prospective study of the risk factors in extracapsular surgery was carried out between October 1984 and April 1986. One thousand extracapsular cataract extractions were performed by seven physicians. Decreasing pupil size was the only statistically significant risk factor for vitreous loss (P = 0.0002). Zonular breaks occurred more commonly with pseudoexfoliation syndrome (PX) (P less than 0.0001), with decreasing pupil size (P less than 0.0001), and with one surgeon who used the Simcoe aspirating needle (Storz) exclusively (P = 0.0001). It is acknowledged that it is very difficult to standardize what constitutes a small zonular break; hence, the increase in zonular breaks recorded by this surgeon may have been due only to his using less stringent criteria than the others. Capsule breaks had no significant risk factors at the 0.01 level. High myopia, advanced cataract, glaucoma, advanced age, and diabetes mellitus were not found to be risk factors for vitreous loss, zonular breaks, or capsular breaks.