title: Prospective evaluation of phacoemulsification in adults younger than 50 years.
abstract: OBJECTIVE
  To evaluate intraoperative performance and long-term outcome of phacoemulsification in patients younger than 50 years.
  
  
  METHODS
  Iladevi cataract and IOL Research Centre, Ahmedabad, India.
  
  
  METHODS
  A prospective observational study was conducted comprising 54 patients (35 men and 19 women) under age 50 who had phacoemulsification. Preoperative evaluation included specular microscopy. Phacoemulsification with implantation of an AcrySof MA30BA intraocular lens (IOL) was performed. Intraoperatively, peripheral extension of capsulorhexis, intraoperative posterior capsule opacification (PCO; plaque), and serious complications (eg, posterior capsule rupture, vitreous loss) were noted. Postoperatively, endothelial cell loss, postoperative PCO, neodymium:YAG (Nd:YAG) laser posterior capsulotomy rate, and best corrected visual acuity (BCVA) were assessed for 3 years. Patients with intraoperative PCO were analyzed separately.
  
  
  RESULTS
  Mean patient age was 42.7 years +/- 5.2 SD (men) and 43.1 +/- 3.25 years (women). Continuous curvilinear capsulorhexis was achieved in 49 patients (90.7%). Intraoperative PCO was present in 14 (25.92%) patients. An Nd:YAG laser posterior capsulotomy was performed in 4 patients (28.5%). Posterior capsule rupture leading to vitreous loss occurred in 1 patient (1.85%). At 3-year follow-up, endothelial cell loss was 5.9%. Postoperative PCO developed in 8 patients (22.2%), and Nd:YAG laser posterior capsulotomy was performed in 5 patients (13.8%). The BCVA was > or = 20/40 in 47 patients (94%).
  
  
  CONCLUSIONS
  Young patients pose a challenge in creating a capsulorhexis and display significant incidence of intraoperative and postoperative PCO.
authors.affiliation: Iladevi Cataract and IOL Research Centre, Gurukul Road, Memnagar, Ahmedabad, India.
authors.forename: Sheena A
authors.initials: SA
authors.lastname: Dholakia
authors.forename: Abhay R
authors.initials: AR
authors.lastname: Vasavada
authors.forename: Raminder
authors.initials: R
authors.lastname: Singh
mesh_terms: D000328:Adult; D019923:Capsulorhexis; D002386:Cataract / Q000209:etiology; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D053685:Laser Therapy; D007903:Lens Capsule, Crystalline / Q000473:pathology / Q000601:surgery; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications; D011446:Prospective Studies