Incidence and factors associated with complications of sutured and sutureless cataract surgery following pars plana vitrectomy at a tertiary referral centre in Turkey

Br J Ophthalmol. 2016 Sep;100(9):1206-10. doi: 10.1136/bjophthalmol-2015-307001. Epub 2015 Dec 16.

Abstract

Aims: To evaluate the incidence of and factors contributing to intraoperative and postoperative complications of eyes with previous pars plana vitrectomy (PPV) undergoing phacoemulsification and intraocular lens (IOL) implantation for cataract.

Methods: The intraoperative and postoperative complications and observations in 513 eyes of 485 patients with previous PPV undergoing sutured and sutureless cataract surgery were assessed. Associations between preoperative characteristics and complications during and after the surgery were explored.

Results: The median interval from PPV to cataract surgery was 15.7±19.5 months. The mean follow-up period was 35.1±31.4 months. Intraoperative complications and observations were: posterior capsular plaque in 50 eyes (9.7%), posterior capsule rupture in 28 eyes (5.5%), loss of nuclear material into vitreous in 17 eyes (3.3%), and zonular dialysis in 12 eyes (2.3%). The most common postoperative complication was posterior capsular opacification (PCO) in 171 eyes (33.3%). PCO correlated with duration of PPV (p<0.001), younger age (p=0.003), and shorter interval from PPV to cataract surgery (p=0.01). Higher rates of postoperative IOL decentration and dislocation correlated with male sex, 20-gauge PPV, 20-gauge PPV with scleral buckling surgery (p<0.001), and longer interval from PPV to silicone oil extraction (p=0.006). Endophthalmitis was not observed in either the sutured or sutureless groups of patients.

Conclusions: Longer duration of PPV surgery, a longer interval from PPV to silicone oil extraction, prior 20-gauge PPV, and 20-gauge PPV with scleral buckling surgery seem to influence the safety and outcomes of cataract surgery. Sutureless phacoemulsification in vitrectomised eyes was not associated with a higher incidence of endophthalmitis, suprachoroidal effusion or haemorrhage.

Keywords: Lens and zonules; Retina.

MeSH terms

  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Intraoperative Complications / epidemiology*
  • Male
  • Middle Aged
  • Phacoemulsification / adverse effects*
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • Suture Techniques / adverse effects*
  • Tertiary Care Centers*
  • Time Factors
  • Turkey / epidemiology
  • Vitrectomy / methods*