Ocular Complications Associated With Cataract Surgery in United States Veterans

Abstract

Purpose: : To investigate the prevalence and predictors of intraoperative and 90-day postoperative ocular complications from cataract surgery in the United States (US) Veterans Health Administration (VHA).

Methods: : The VHA National Patient Care Database (NPCD) was used to identify all patients who underwent outpatient extracapsular cataract surgery and had only one cataract surgery within 90 days of the index surgery between October 1, 2005 and September 30, 2007. The prevalence of demographic factors, preoperative systemic and ocular comorbidities, intraoperative complications, and 90-day postoperative complications was collected. Predictors of complications were identified by calculating adjusted odds ratios (OR) using logistical regression modeling.

Results: : Of 53,786 veterans who underwent cataract surgery during the study period, 45,082 met inclusion criteria. The most prevalent preoperative systemic and ocular comorbidities included diabetes mellitus (40.6%), chronic obstructive pulmonary disease (21.2%), age-related macular degeneration (14.4%), and diabetes with ophthalmic manifestations (14.0%). The most prevalent ocular complications were posterior capsular tear and/or anterior vitrectomy intraoperatively (3.5%) and posterior capsular opacification postoperatively (4.2%). Significant predictors of complications included: black race (OR, 1.38 [95% confidence interval, 1.28,1.50]), divorced (1.10 [1.03,1.18]), never married (1.26 [1.14,1.38]), diabetes with ophthalmic manifestations (1.33 [1.23,1.43]), traumatic cataract (1.80 [1.40,2.31]), previous ocular surgery (1.29 [1.02,1.63]), and older age.

Conclusions: : Selected demographic factors and ocular comorbidities were associated with greater risks of cataract surgery complications in the VHA. Further large-scale studies are warranted to investigate cataract surgery outcomes for other US patient populations.

Keywords: cataract • clinical (human) or epidemiologic studies: outcomes/complications