INTRAOPERATIVE COMPLICATIONS OF 1000 PHACOEMULSIFICATION PROCEDURES -A PROSPECTIVE-STUDY

Purpose: To determine the frequency and nature of intraoperative compl ications of endocapsular phacoemulsification cataract surgery. Setting : Dalcross Private Hospital and the Departments of Ophthalmology, Conc ord Hospital and Prince of Wales Hospital, Sydney, Australia. Methods: This prospective study included the first 1000 cases oi planned endoc apsular phacoemulsification cataract surgery performed by an experienc ed surgeon. A standardized proforma was completed at the time of surge ry. Data recorded included pie-existing ocular abnormalities duration of surgery, nuclear sclerosis grade, and intraoperative complications. Results: Major complications comprised posterior capsule tears with v itreous loss (1.4%) isolated posterior capsule tears (0.7%), and zonul ysis (0.1%). Minor complications included anterior capsule tears (3.8% ), iris prolapse(0.6%), and ciliary body incision (0.2%). There was a significant trend toward complications as the nuclear sclerosis grade increased. The incidence of major complications was 9.3% in the first 150 cases and 0.9% in the last 850. This represents relative risk of 9 .9 (95% confidence interval 4.2 to 23.0) of a major complication occur ring in the first 150 compared with the later 850 cases. Conclusion: T he frequency of major and minor complications fell sharply after the f irst 150 operations and was maintained. This study may provide a guide for beginning phacoemulsification surgeons and a basis for experience d surgeons to compare their performance outcomes.