Postoperative aphakia in modern cataract surgery: part 2: detailed analysis of the cause of aphakia and the visual outcome.
OBJECTIVE
To study the incidence of aphakia after cataract surgery, the surgical complications that can lead to it, and the visual outcome.


METHODS
Six community-run eye clinics participating in the Swedish National Cataract Register.


METHODS
Data on cataract extractions were collected prospectively from 1997 through 2001. The data also covered the type of surgery and type of intraocular lens, including a "no lens implanted" option. All data were stored in a database. These data were supplemented with data on the intended type of surgery, type of complications, possible second surgery, and visual outcome.


RESULTS
The overall incidence of postoperative aphakia was 0.65%. In 87.1% of cases, the aphakia was not planned, corresponding to an incidence of 0.48%. Unplanned aphakia was significantly related to poor preoperative vision, old age, and the presence of ocular comorbidity. The most frequent reasons for unplanned aphakia were intraoperative capsule problems and vitreous loss. In two thirds of cases, a second operation was performed. In 41% of all cases, the final visual acuity was 0.5 or better and in 27.7%, worse than 0.1.


CONCLUSIONS
During the study period, 1 of every 200 routine cataract surgeries ended in unplanned aphakia. The incidence of surgical complications leading to unplanned aphakia and a final visual acuity worse than 0.1 (20/200) was 7.8 per 10,000 operations in cases with no ocular comorbidity and 27.6 per 10,000 operations in cases with ocular comorbidity.
Department of Ophthalmology, Blekinge Hospital, Linköping, Sweden. mats.lundstrom@ltblekinge.se
Mats
M
Lundström
Klas Göran
KG
Brege
Ingrid
I
Florén
Björn
B
Lundh
Ulf
U
Stenevi
William
W
Thorburn
D000368:Aged; D001036:Aphakia, Postcataract / Q000453:epidemiology / Q000209:etiology*; D002387:Cataract Extraction; D005260:Female; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D014792:Visual Acuity / Q000502:physiology*