Vitreous loss during conversion from conventional extracapsular cataract extraction to phacoemulsification.
OBJECTIVE
To study the outcome of vitreous loss among senior surgeons converting from conventional extracapsular cataract extraction (ECCE) to phacoemulsification.


METHODS
A university teaching hospital in the United Kingdom.


METHODS
A retrospective analysis of 87 planned cataract extractions performed from January 1992 to December 1996 and complicated by vitreous loss was done. Outcome measures included postoperative complication rates and visual acuity.


RESULTS
During the study, vitreous loss occurred in 39 patients having ECCE and in 48 having phacoemulsification; the latter group included 8 patients with dropped nucleus. Postoperative complications included cystoid macular edema (18.7% of phaco patients, 30.8% of ECCE patients), retinal detachment (2.1% of phaco patients, 5.1% of ECCE patients), and expulsive hemorrhage (5.1% of ECCE patients). Phaco patients had higher rates of postoperative corneal edema (27.1%) than ECCE patients (12.8%) and transient intraocular pressure elevation (33.3%) versus 20.5%) but were more likely to receive posterior chamber intraocular lenses (70.8% versus 35.9%; P = .0024, chi-square test). After excluding pre-existing diseases, 83.3% of phaco patients and 67.6% of ECCE patients achieved a visual acuity of 6/12 or better.


CONCLUSIONS
With careful patient selection, experienced extracapsular surgeons converting to phacoemulsification can achieve favorable results even in the presence of complications such as vitreous loss or dropped nucleus.
Ah-Fat
F G
FG
St. Paul's Eye Unit, Royal Liverpool University Hospital, United Kingdom.
Sharma
M K
MK
Majid
M A
MA
Yang
Y C
YC
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction / Q000009:adverse effects / Q000592:standards; D002983:Clinical Competence; D005128:Eye Diseases / Q000209:etiology / Q000473:pathology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007431:Intraoperative Complications / Q000473:pathology; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000193:education*; D018918:Phacoemulsification / Q000009:adverse effects / Q000592:standards*; D011183:Postoperative Complications / Q000473:pathology; D012189:Retrospective Studies; D006113:United Kingdom; D014792:Visual Acuity; D014822:Vitreous Body / Q000473:pathology*