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Jonathon Ng, Nigel Morlet, Antony Clark; Anterior vitrectomy at the time of cataract surgery: A whole-population study of the incidence and consequences. Invest. Ophthalmol. Vis. Sci. 2013;54(15):893.
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To determine the incidence and consequences of anterior vitrectomy during cataract surgery.
We used the Western Australian Data Linkage System to identify patients that had cataract surgery in all public and private hospitals in Western Australia in 1980-2001. Procedures that had an anterior vitrectomy during cataract surgery were identified using clinical procedure codes. Potential sight-threatening complications were identified as those patients who underwent subsequent eye surgery for the complication of interest following initial cataract surgery. These potential cases were validated using the medical record.
There were 129,982 cataract surgeries performed with 1,342 (10.3%) requiring anterior vitrectomy. The incidence of anterior vitrectomy varied from 5-13 per 1,000 procedures. There were two peaks in incidence of anterior vitrectomy at the time of cataract surgery; the early 1980s and early 1990s, which coincided with transitions in surgical technique. A sight-threatening complication subsequently occurred in 152 (11.3%) of the cataract surgeries involving anterior vitrectomy. This included 50 (3.7%) retinal detachments, 9 (0.7%) pseudophakic bullous keratopathy, 35 (2.6%) IOL dislocations, 55 (4.1%) dropped nuclei and 6 (0.4%) endophthalmitis cases.
Anterior vitrectomy rates mirror learning curves associated with the adoption of new surgical techniques. Patients requiring anterior vitrectomy had a higher risk of other complications.
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