PHACOEMULSIFICATION AT KING-KHALED-EYE-SPECIALIST-HOSPITAL - THE EXPERIENCE OF THE PAST

Objective: To study the outcome of phacoemulsification (PE) compared t o standard extracapsular surgery before the introduction of state-of-t he-art techniques (capsulorhexis, hydrodissection, nuclear cracking, n uclear chopping, sutureless incisions) and sophisticated equipment. St udy design: Charts from 375 patients (453 eyes) undergoing PE between 1984 and 1989 were randomly selected and studied retrospectively. A mi nimum age of 35 years, and a minimum follow-up of three months were re quired. Setting: A large eye hospital in the Kingdom of Saudi Arabia s taffed with an international faculty of ophthalmic surgeons. Patients: Patients over 35 years of age undergoing PE for immature, mature and traumatic cataract. Main outcome measures: Postoperative visual acuity , and rate or frequency of intraoperative complications. Results: 66.5 % achieved visual acuity of 20/40 or better, which compares favourably with the 36.5% of eyes reaching this level of visual acuity after mai nly standard extracapsular cataract surgery in another study at our ho spital. Posterior capsule ruptures occurred in 7.5% and vitreous loss in 5.5%. Other ocular disease (odds ratio 7.51 confidence interval 4.4 3-12.7) and intraoperative complications (odds ratio 2.97 confidence i nterval 1.38-6.42) were statistically significant predictors for final visual acuity of under 20/40 (p = <0.001 and 0.005 respectively). Con clusion: The outcome of PE was better than that of standard extracapsu lar cataract extraction in the same setting. However, since PE appeare d to be used selectively, no clear advantage compared to extracapsular cataract extraction is evident in the period before the introduction of modern state-of-the-art PE-techniques.