title: Whole population trends in complications of cataract surgery over 22 years in Western Australia.
abstract: OBJECTIVE
  To examine the trends in major complications of cataract surgery in the Western Australian population over 22 years.
  
  
  METHODS
  Population-based study.
  
  
  METHODS
  We included 129 982 cataract/lens surgery patients across 46 health facilities.
  
  
  METHODS
  Using the Western Australian Data Linkage System, we identified all patients who underwent cataract/lens surgery in Western Australia between 1980 and 2001. Complications of interest were identified from those patients admitted to hospital or who underwent unplanned surgery after cataract surgery and were validated by medical record review.
  
  
  METHODS
  Admission for retinal detachment, dropped nucleus, wound dehiscence, pseudophakic corneal edema, intraocular lens (IOL) dislocation, and postoperative endophthalmitis requiring surgery.
  
  
  RESULTS
  There were 129 982 cataract/lens procedures and 2087 (1.6%) complications. Complications fell almost 70% over the study period. Retinal detachment (n = 905; 0.70%) was most common, followed by IOL dislocation (n = 361; 0.28%), endophthalmitis (n = 228; 0.18%), wound dehiscence (n = 227; 0.17%), pseudophakic corneal edema (n = 207; 0.16%), and dropped nucleus (n = 159; 0.12%). The incidence of complications lessened over time, except for IOL dislocations, which has increased since 1995. Overall, the risk of complications after phacoemulsification halved since it was introduced in the late 1990s (incidence rate ratio, 0.52; 95% confidence interval, 0.37-0.74), whereas complications after extracapsular extraction (ECCE) have increased over recent years.
  
  
  CONCLUSIONS
  Cataract surgery remains an extremely safe procedure with comparatively few major complications. Changes in operative techniques have been accompanied by a significant decrease in complication rates over time, although the increase in IOL dislocations and complications after ECCE warrants further study.
  
  
  BACKGROUND
  The authors have no proprietary or commercial interest in any of the materials discussed in this article.
authors.affiliation: Eye and Vision Epidemiology Research Group, Perth, Western Australia. a.clark@curtin.edu.au
authors.forename: Antony
authors.initials: A
authors.lastname: Clark
authors.forename: Nigel
authors.initials: N
authors.lastname: Morlet
authors.forename: Jonathon Q
authors.initials: JQ
authors.lastname: Ng
authors.forename: David B
authors.initials: DB
authors.lastname: Preen
authors.forename: James B
authors.initials: JB
authors.lastname: Semmens
mesh_terms: D000368:Aged; D002386:Cataract / Q000453:epidemiology*; D002387:Cataract Extraction / Q000009:adverse effects*; D009877:Endophthalmitis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D011159:Population Surveillance; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D014904:Western Australia / Q000453:epidemiology