K. Ninnpedersen et U. Stenevi, CATARACT-SURGERY IN A SWEDISH POPULATION - OBSERVATIONS AND COMPLICATIONS, Journal of cataract and refractive surgery, 22(10), 1996, pp. 1498-1505
Purpose: To describe relevant clinical conditions at cataract surgery
in a defined Swedish population, examine variables and their influence
on the operative procedure, and estimate the risk of complications at
surgery. Setting: Department of Ophthalmology, Lund University Hospit
al, Sweden. Methods: Using the Cataract Analysis System(TM), data were
prospectively collected on 5878 consecutive cataract surgeries perfor
med in a single Swedish health care district from 1986 to 1990. Patien
ts younger than 15 years were not included. The study population was c
omplete enough to represent all cataract surgeries in the referral reg
ion of the Lund Health Care District during this period. The incidence
of zonular or lens capsule rupture at surgery was used as a measure o
f surgical complications and assessed as a function of other preoperat
ive and surgical parameters. A logistic regression model was used to a
ssess the probability of complications at surgery. Results: Glaucoma w
as the highest statistically significant preoperative risk factor for
capsular or zonular rupture at surgery, with or without vitreous loss,
with a relative risk of 2.7 (i.e., a 2.7-fold increase in risk over p
atients without glaucoma). Surgeons performing fewer than 40 operation
s in 5 years had a relative risk of zonular or capsular rupture of app
roximately 2.9 (i.e., a 2.9-fold increase in risk over high-volume sur
geons). The overall risk was 2.5%. Conclusion: Cataract patients with
glaucoma have an increased risk of complications at surgery. Surgeons
performing few operations tended to have more capsular or zonular rupt
ures.