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Complication rate of posterior capsule rupture with vitreous loss during phacoemulsification at a Hawaiian cataract surgical center: a clinical audit

Authors Chen M, LaMattina K, Patrianakos T, Dwarakanathan S

Received 17 November 2013

Accepted for publication 16 December 2013

Published 5 February 2014 Volume 2014:8 Pages 375—378


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Ming Chen,1 Kara C LaMattina,2 Thomas Patrianakos,2 Surendar Dwarakanathan2

1Department of Surgery, Division of Ophthalmology, University of Hawaii, Honolulu, HI, USA; 2Division of Ophthalmology, John H Stroger, Jr Hospital of Cook County, Chicago, IL, USA

Purpose: To compare the complication rate of posterior capsule rupture (PCR) with vitreous loss during phacoemulsification at an ambulatory surgical center with published results as a clinical audit for quality control.
Methods: A retrospective chart review of 3,339 consecutive patients who underwent routine phacoemulsification by four experienced private practice surgeons from January 1, 2011 to June 30, 2012 at The Surgical Suites, Honolulu, HI, USA. All cases with PCR and vitreous loss were identified and selected for the study. Risk factors of this complication were further examined. Data were sent to John H Stroger Jr Hospital of Cook County, Division of Ophthalmology, for literature review, analysis, and write-up.
Results: Twenty-three of the 3,339 cases incurred PCR and vitreous loss during phacoemulsification, for an incidence rate of 0.68%. Miosis, shallow chamber, restlessness, pseudoexfoliation syndrome, floppy iris syndrome, and zonulopathy were the main causes. In addition, surgeon volume (number of cases) was inversely correlated with PCR.
Conclusion: The rate of PCR with vitreous loss during phacoemulsification in this study may be lower than other published results done at academic centers. However, there was no compatible study available for comparison, as existing studies performed at academic centers included resident cases. This study identified risk factors for PCR/vitreous loss both preoperatively and postoperatively that may assist in application of preventive measures to decrease rates of PCR/vitreous loss.

Keywords: phacoemulsification complications, posterior capsule rupture, vitreous loss, vitrectomy, miosis, pseudoexfoliation, floppy iris syndrome, zonulopathy

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