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Erol Eri Verter, Tulay Cakiner-Egilmez, Luis Alonso Gonzalez, Amy Chomsky, Elizabeth Baze, David Vollman, Mary Gilbert Lawrence, Mary K Daly; Association of Age with Surgical Complications and Visual Outcomes Following Cataract Surgery: Results of the Ophthalmic Surgical Outcomes Data Project. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1574.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze the association of age and complications and visual outcomes of cataract surgery in the veteran population.
We included 4897 of 4923 eyes from the Ophthalmic Surgical Outcomes Data Project (OSOD), a multicenter retrospective cohort analysis from five VAMC sites. Data were collected according to OSOD definitions. Baseline variables included ASA class, gender, BMI, diabetes mellitus, hypertension, glaucoma, and small pupil. Outcome variables were: BCVA, minor and major complications, and intraoperative events. Fisher's exact, chi square, and McNemar's tests were used for statistical analysis. A longitudinal data analysis using multivariate logistic regression for the main outcome, and multivariable logistic regression models for secondary outcomes were performed adjusting for potential confounders.
We categorized included cases into six age groups: <50 (min 28, 0.75%, n=37), 50-57 (9.7%, n=479), 60-69 (38.9%, n=1909), 70-79 (29.7%, n=1453), 80-89 (19.7%, n=969) and >90 (1%, n=50) years old. Overall, 90.7% of those with BCVA worse than 20/40 improved to 20/40 or better after the surgery (p<0.0001). We found that the percentage of improvement was significant across all age groups (95% in <50, 94.7% in 50-59, 92.5% in 60-69, 91.1% in 70-79, 84.7% in 80-89, and 90.9% in >90, p<0.0001 for all). We found a higher prevalence of intraoperative events as age increased; higher use of pupillary expansion devices (9.6% in patients 70-79, 13.3% in 80-89, and 30.0% in >90 years, p<0.001); higher prevalence of posterior capsular tear, vitreous prolapse, and anterior vitrectomy in patients older than 90 years compared to the younger (p<0.02, P<0.03 and p<0.01 respectively). Although age was significantly associated with the final postoperative BCVA, intraoperative events, and minor complications after adjusting for potential confounders, there were no significant differences in the occurrence of major complications.
Our results show that intraoperative events and minor complications are more prevalent as age increases. After accounting for potential confounders, we found that increasing age is associated with lower prevalence of BCVA of 20/40 or better, however, a significant visual improvement was observed in all groups, suggesting cataract surgery is beneficial in all groups of the OSOD.
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