title: Factors affecting cataract surgery complications and their effect on the postoperative outcome.
abstract: OBJECTIVE
  To identify factors associated with the development of complications during or after cataract surgery and to determine the effect of complications on improvements in visual acuity and visual function.
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  A total of 4335 patients at 17 hospitals in the Spanish National Health Service undergoing cataract removal by phacoemulsification.
  
  
  METHODS
  Clinical data were collected before the intervention and 6 weeks postoperatively. All patients were mailed the Visual Function Index (VF-14) and additional questions concerning their ocular disease, preoperatively and 3 months after surgery. Logistic regression models were used to identify factors associated with the presence of complications, and general linear models to study the effect of complications on changes in visual acuity and VF-14 scores.
  
  
  RESULTS
  Some type of perioperative complication was found in 10.35% of patients and postoperative complications in 26.63%. Age, visual acuity greater than 0.3, moderate or high technical complexity, and the presence of perioperative complications, such as posterior capsular rupture or vitreous hemorrhage, were most strongly associated with the development of postoperative complications. Patients who had either perioperative or postoperative complications had lower levels of preoperative and postoperative visual acuity levels and visual function, and less improvement was seen for these parameters.
  
  
  CONCLUSIONS
  We identified factors associated with the development of surgery-related complications and showed that the presence of complications is associated with poorer postoperative visual acuity and function. These findings are useful for health care management, clinical decision making, and providing patients and clinicians with realistic expectations.
authors: Research Unit, Hospital Galdakao-Usansolo (Osakidetza)-Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Galdakao, Bizkaia, Spain. Electronic address: nerea.gonzalezhernandez@osakidetza.net.
authors: Nerea
authors: N
authors: González
authors: Research Unit, Hospital Galdakao-Usansolo (Osakidetza)-Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Galdakao, Bizkaia, Spain.
authors: Jose M
authors: JM
authors: Quintana
authors: Research Unit, Hospital Universitario Basurto (Osakidetza)-REDISSEC, Madrid, Spain.
authors: Amaia
authors: A
authors: Bilbao
authors: Quality Unit, Hospital de Valme, Sevilla, Galdakao, Bizkaia, Spain.
authors: Silvia
authors: S
authors: Vidal
authors: Technology and Health Innovation General Subdepartment, Department of Health of the Community of Madrid-Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Madrid, Spain.
authors: Nerea
authors: N
authors: Fernández de Larrea
authors: Ophthalmology Service, Hospital Galdakao-Usansolo (Osakidetza), Galdakao, Bizkaia, Spain.
authors: Victoria
authors: V
authors: Díaz
authors: Ophthalmology Service, Hospital de Sabadell, Sabadell, Spain.
authors: Josep
authors: J
authors: Gracia
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D011183:Postoperative Complications; D012307:Risk Factors; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology