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Outcomes of Cataract Surgery Complicated With Zonular Dialysis: A Multicenter Comparative Study.
Abdelrahman M Elhusseiny1, Joseph Toma1,2, Yousef A Fouad2
1Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AS, USA.
Current Eye Research
|October 30, 2024
Summary
Phacoemulsification with zonular dialysis (ZD) leads to worse visual outcomes and increased risks of complications like cystoid macular edema (CME). Early identification and management of ZD are crucial for better patient results in cataract surgery.
Area of Science:
- Ophthalmology
- Surgical Outcomes
- Cataract Surgery
Background:
- Phacoemulsification is a common cataract surgery technique.
- Zonular dialysis (ZD) can occur during phacoemulsification, potentially impacting surgical outcomes.
- Understanding the implications of ZD is vital for improving patient care.
Purpose of the Study:
- To compare visual outcomes, cystoid macular edema (CME) rates, and associated complications in eyes with intraoperative zonular dialysis (ZD) versus uneventful phacoemulsification.
- To identify risk factors associated with ZD during cataract surgery.
Main Methods:
- A retrospective multicenter comparative database study.
- Data from 1074 eyes with ZD and 112,479 reference eyes were analyzed.
- Postoperative visual acuity (VA) and complication rates (CME, vitreous loss, posterior capsular rupture) were compared.
Main Results:
- Eyes with ZD had significantly worse postoperative VA compared to the reference group.
- Pseudoexfoliation and prior glaucoma surgery were strong predictors of ZD.
- The ZD group experienced higher rates of vitreous loss (34.3%), posterior capsular rupture (11.1%), and CME (2.3% vs. 1.4%).
Conclusions:
- Zonular dialysis during phacoemulsification is linked to poorer visual acuity post-surgery.
- ZD increases the likelihood of intraoperative complications and postoperative cystoid macular edema.
- Management strategies should address the increased risks associated with ZD in cataract surgery.
