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R. Wee, Z.K. Ferrufino–Ponce, S.L. Cremers, B.A. Henderson; Incidence and Causes of Re–Operation After Cataract Surgery . Invest. Ophthalmol. Vis. Sci. 2005;46(13):759.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: 1) to compare re–operation rates between resident–performed and attending–performed cataract extraction cases, 2) to determine reasons for re–operation, and 3) to compare best–corrected visual acuity at 1 month post–op in patients requiring re–operation versus those who did not require re–operation. Methods: In a retrospective study of all cataract extraction cases from 2001–2004 at the Massachusetts Eye and Ear Infirmary performed by or supervised by two attending ophthalmologists in the Comprehensive Ophthalmology Service, patient records from 1416 cases were reviewed for the need to bring the patient back to the operating room. The cases were divided into resident–performed cases versus attending–performed cases. Additional factors such as pseudoexfoliation syndrome, diabetes, glaucoma, macular degeneration, phacoemulsification technique, and previous intraocular surgery were analyzed for correlation with the need to re–operate. Best–corrected visual acuity was compared at one month in the re–operated group versus the non–reoperated group. Results: Of 1416 cataract surgeries, re–operation was required in 20 cases (1.4%). Reasons included exchanging the IOL (8), repositioning the IOL (5), recovering a dropped lens (4), stabilizing a wound leak (1), placing a secondary ACIOL (1), and performing a vitrectomy/membrane peel for BRVO (1). In 0.67% (1 of 150 cases) of attending cases, the patient required re–operation versus 1.5% (19 of 1266 cases) of resident cases (p=0.26). The Fisher Exact Test reveals that of the conditions mentioned in the methods section, only previous intraocular surgery is correlated with the need for re–operation. 5.4% of patients (4 of 74 cases) with previous intraocular surgery required re–operation (p<0.03). Patients requiring re–operation had worse vision post–op (LogMAR 0.37+0.32 SD) than those not requiring re–operation (LogMAR 0.20+0.36 SD) (p<0.05) despite having similar pre–op vision (LogMAR 0.55+0.30 SD vs. LogMAR 0.59+0.50 SD, p=0.65). Conclusions: Resident–performed cataract extraction cases have a low rate of re–operation comparable to that of attending–performed cases with no statistically significant difference. The rate of complications observed in our study is consistent with published rates. Previous intraocular surgery is correlated with a higher re–operation rate after cataract surgery, and the need for re–operation is correlated with a worse visual acuity.
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