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Addou Regnard Manar, Franck Fajnkuchen, Anh Bui, Gilles Chaine, Audrey Giocanti-Auregan, ; Impact of lens thickness on hyper mature cataract surgical complications: preliminary results of a prospective study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2813.
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Complications during white hyper mature cataract surgery are often unpredictable. Lens density can be assessed by pentacam, but this tool is not commonly available. Hence, a parameter correlated with surgery difficulty easier to assess would be useful. Our purpose was to assess the correlation between lens thickness (LT) and surgery complications.
We conducted a prospective, observational, and monocentric study. We included all patients operated on for white hyper mature cataract from january to november 2013. We selected patients with a visual acuity (VA) lower than 20/200 on the Monoyer scale. We excluded patients suspect of zonula fibers weakness due to trauma or pseudoexfoliation. Morphological features assessed were LT, axial length, depth of anterior chamber and vitreous length, measured by A ulrasound scan (Ocuscan, Alcon Laboratories, Inc.). The other parameters assessed were the surgical duration , occurrence of complications during surgery, VA and corneal edema at the seventh day after surgery (analogic scale from 0 to 3).
We included 30 eyes of 29 patients. Mean LT was 4,19 ± 0,68 mm, with a median of 3,89 mm. The mean values of axial length, depth of anterior chamber and vitreous length were respectively 23,15 ± 1,58 mm, 3,17 ± 0,55 mm and 15,81 ± 1,6 mm. The mean duration of surgery was 26,37 ± 10,11 min. Complications during surgery occurred in 4 patients (4 capsular rupture, with one posterior lens dislocation). The Mean VA at the seventh day was 0,4 ± 0,33 (decimal scale). One third of patients had a corneal edema at the seventh day after surgery, severe for 3 cases (rate 3 on a scale from 0 to 3). The Pearson correlation coefficient between visual acuity and LT was -0,53. Other parameters were not correlated.
LT did not seem to be a marker of a longer surgical duration. VA at the seventh day seemed to be inversely correlated to LT. Likewise, complications during surgery seemed to happen more frequently when the lens was thicker. This parameter may be related to a higher rate of complications during surgery.
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