Prognostic factors that determine visual outcome following cataract surgery complicated by vitreous loss.
OBJECTIVE
To identify prognostic factors that determine visual outcome following phacoemulsification cataract surgery complicated by vitreous loss.


METHODS
A retrospective cohort study. All cases of vitreous loss during phacoemulsification surgery at a university hospital, between June 2000 and December 2005, were identified from the hospital computer database. By reviewing the medical notes, preoperative, intraoperative, and postoperative data were collected. Outcome of interest was presence of poor visual outcome (best-corrected visual acuity [BCVA] <6/12). Chi-square and Mann-Whitney U tests were used to compare groups of poor and good visual outcome.


RESULTS
A total of 230 consecutive cases (eyes) were identified; medical notes were available for 228. Mean patient age was 78.4 years (SD 11); median follow-up 13.4 weeks (range 1-203). In multivariable logistic regression analysis poor visual outcome was independently associated with poor preoperative vision (BCVA <6/12) (OR 3.78, 95% CI 1.76-8.11), age-related macular degeneration (OR 3.04, 95% CI 1.16-8.00), cystoid macular edema (OR 3.85, 95% CI 1.29-11.51), and secondary pars plana vitrectomy (PPV) for nuclear fragment loss (OR 4.42, 95% CI 1.03-19.02). Primary PPV for nuclear fragment loss, age >70, ocular comorbidity, axial length, vitreous loss during irrigation/aspiration, or lens implantation, anterior chamber lens, and secondary lens implantation were not significant associations (p>or= 0.05). In 33 (14.5%) eyes BCVA was reduced by at least one Snellen line compared to before surgery.


CONCLUSIONS
Poor visual outcome was associated with poor preoperative vision, age-related macular degeneration, cystoid macular edema, and secondary PPV following nuclear fragment loss. Primary PPV for nuclear fragment loss was not a significant association.
Konstantopoulos
Aristides
A
Southampton Eye Unit, Southampton General Hospital, Southampton - UK. ariskons@yahoo.com
Yadegarfar
Ghasem
G
Madhusudhana
Khrishnapa
K
Canning
Chris
C
Luff
Andrew
A
Anderson
David
D
Hossain
Parwez
P
D000368:Aged; D005128:Eye Diseases / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*; D014822:Vitreous Body / Q000473:pathology*