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K. L. Whitcroft, N. Patel, G. Larkin; Pre-Existing Ocular Conditions and Complication Risk in Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5392.
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Cataract operations are the most common elective procedure performed in the UK. Advances in surgical technique have greatly reduced the risk associated with such operations. However, complications do still occur and can cause long-term detriment to the patient. Previous studies have addressed complication rates but the relationship between specific pre-existing conditions and complication risk has not yet been fully elucidated. The purpose of this study was therefore to determine whether pre-existing ocular conditions increase the risk of mild, moderate or severe complications and to quantify any such relationships.
An electronic data set was prospectively compiled for cataract operations performed at King’s College Hospital from 2006-9. Information gathered included pre-existing ocular conditions and surgery outcome. Operations with no pre-existing conditions were classified as control. All others were grouped according to condition type. The frequencies of mild, moderate and severe complications in each group were compared with control using a chi-squared test. Relative risks (RR) were then calculated for each statistically significant result (p<0.05).
7702 control operations and 2071 operations with pre-existing ocular conditions were included. Total complication rates were 2.64% and 6.81% respectively. The risk of mild complications was significantly increased by pre-existing uveitis/synechiae, pseudoexfoliation/phacodonesis, brunescent/white cataract, high myopia, diabetic retinopathy or previous vitrectomy with RR of 3.69, 6.22, 7.46, 2.64, 3.12 and 9.54 respectively. The risk of moderate complications was significantly increased by corneal pathology, pseudoexfoliation/phacodonesis, brunescent/white cataract or reduced fundal view/vitreous opacities with RR of 2.94, 8.89, 6.43 and 8.79 respectively. The risk of severe complications was significantly increased by brunescent/white cataract only with RR of 15.97.
We have shown that the risk of complications is affected to varying degrees by different pre-existing ocular conditions. The results of this study will therefore enable surgeons to provide more individualised counselling to patients before undergoing cataract surgery.
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