Risk of zonular dialysis in fellow eye cataract surgeries: multicenter comparative study

Area of Science:

• Ophthalmology
• Surgical Outcomes
• Patient Safety

Background:

• Phacoemulsification cataract surgery is a common procedure.
• Zonular dialysis (ZD) is a potential complication during cataract surgery.
• Understanding risk factors for ZD in the fellow eye is important for surgical planning and patient counseling.

Purpose of the Study:

• To evaluate the incidence of zonular dialysis (ZD) in the fellow eye during cataract surgery.
• To identify significant risk factors associated with ZD in the fellow eye, with a focus on prior ZD in the first eye.

Main Methods:

• A retrospective database study was conducted across 8 UK National Health Service clinical centers.
• Data from 66,288 patients undergoing cataract surgery were analyzed.
• The risk of intraoperative ZD in the fellow eye was calculated, and odds ratios for various risk factors were determined.

Main Results:

• The overall incidence of intraoperative ZD was 0.5% in the first eye and 0.5% in the fellow eye.
• Patients with prior ZD in the first eye had a significantly higher risk of ZD in the fellow eye (6.9% vs 0.5%, unadjusted OR 14.9).
• First eye ZD (adjusted OR 13.3) was the most significant predictor, followed by pseudoexfoliation (OR 6), prior pars plana vitrectomy (OR 4.5), and poor pupillary dilation (OR 2.2).

Conclusions:

• The occurrence of zonular dialysis in the first eye is the primary risk factor for developing ZD in the fellow eye during cataract surgery.
• These findings underscore the importance of considering previous ZD when counseling patients and allocating surgical resources.
• Enhanced vigilance and tailored surgical approaches may be warranted for patients with a history of ZD.