Cataract surgery in a Swedish population: observations and complications

To describe relevant clinical conditions at cataract surgery in a defined Swedish population, examine variables and their influence on the operative procedure, and estimate the risk of complications at surgery.

Department of Ophthalmology, Lund University Hospital, Sweden.

Using the Cataract Analysis System, data were prospectively collected on 5878 consecutive cataract surgeries performed in a single Swedish health care district from 1986 to 1990. Patients younger than 15 years were not included. The study population was complete enough to represent all cataract surgeries in the referral region of the Lund Health Care District during this period. The incidence of zonular or lens capsule rupture at surgery was used as a measure of surgical complications and assessed as a function of other preoperative and surgical parameters. A logistic regression model was used to assess the probability of complications at surgery.

Glaucoma was the highest statistically significant preoperative risk factor for capsular or zonular rupture at surgery, with or without vitreous loss, with a relative risk of 2.7 (i.e., a 2.7-fold increase in risk over patients without glaucoma). Surgeons performing fewer than 40 operations in 5 years had a relative risk of zonular or capsular rupture of approximately 2.9 (i.e., a 2.9-fold increase in risk over high-volume surgeons). The overall risk was 2.5%.

Cataract patients with glaucoma have an increased risk of complications at surgery. Surgeons performing few operations tended to have more capsular or zonular ruptures.