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Risk factors affecting visual outcomes following dropped nucleus after cataract surgery.

Jeremy Youwei Hu^1,2,3, Seng-Ei Ti^1,4,5,6, Soon-Phaik Chee^7,8,9,10

¹Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Kent Ridge Crescent Singapore, 119260, Singapore, Singapore.

Eye (London, England)

|August 4, 2023

Summary

A dropped nucleus during phacoemulsification surgery occurred in 0.17% of cases. Most patients achieved good vision, but age, lack of an intraocular lens, and complications impacted outcomes.

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Area of Science:

Ophthalmology
Surgical Outcomes
Retinal Surgery

Background:

Dropped nucleus during phacoemulsification is a known complication.
Understanding visual outcomes and risk factors is crucial for patient management.

Purpose of the Study:

To describe visual outcomes in eyes with a dropped nucleus during phacoemulsification.
To identify risk factors affecting visual success after dropped nucleus management.

Main Methods:

Retrospective chart review of dropped nucleus cases from January 2001 to December 2016.
Analysis included patient demographics, surgeon experience, timing of pars plana vitrectomy (PPV), and complications.
Multivariate logistic regression identified risk factors for visual success (best corrected visual acuity ≥ 20/40).

Main Results:

The incidence of dropped nucleus was 0.17% (292 cases).
85.2% of eyes achieved a best corrected visual acuity of 20/40 or better at final review.
Risk factors for poor visual outcomes included age >70 years, absence of an intraocular lens (IOL) implant, and major complications.

Conclusions:

The overall incidence of dropped nucleus is low (0.17%), with a high rate of visual success (85.2%).
Patient age, IOL implantation, and the presence of major complications significantly influence visual prognosis.
Prompt management with pars plana vitrectomy (PPV) is essential, though timing (same-day vs. delayed) did not impact final visual success.