Risk factors, complications, and results in extracapsular cataract extraction

To examine a large series of extracapsular cataract extractions (ECCEs) to determine the risk factors for posterior capsule rupture with vitreous loss (PCR + VL) and the complications and results of this cataract surgery technique.

North Riding infirmary, Middlesbrough, United Kingdom.

In this retrospective study, the records of 1552 patients who had ECCE performed by two surgeons were examined. Follow-up was 4 months to 4 years. The main outcome measures were the incidence of risk factors, PCR + VL, major and minor postoperative complications, and the visual outcome.

Three hundred twenty-two cases were considered high risk for PCR + VL. In this group, the PCR + VL rate was 5.3%; it was 3.7% in the low-risk group and 4.0% overall. Visual acuity of 6/9 or better was achieved by 76% of all eyes. Postoperative complications were 3 cases of endophthalmitis, 4 of retinal detachment, and 1 of pseudophakic bullous keratopathy. In 323 eyes, loose or broken sutures were removed and in 175, a neodymium: YAG capsulotomy was performed because of posterior capsule opacification.

The incidence of perioperative and postoperative complications was comparable with those reported in other series. Factors that increased the risk of PCR + VL included pseudoexfoliation, diabetes mellitus, and a traumatic etiology. Previous glaucoma surgery and axial myopia of greater than 26.0 mm did not increase the PCR + VL risk. Loose or broken corneal sutures was a common finding that could be reduced substantially by planned suture removal.