Risk factors, complications, and results in extracapsular cataract extraction

Purpose: To examine a large series of extracapsular cataract extractions (ECCEs) to determine the risk factors for posterior capsule rupture with vitreous loss (PCR+VL) and the complications and results of this cataract surgery technique. Setting: North Riding Infirmary, Middlesbrough, United Kingdom. Methods: In this retrospective study, the records of 1552 patients who had ECCE performed by two surgeons were examined. Follow-up was 4 months to 4 years. The main outcome measures were the incidence of risk factors, PCR+VL, major and minor postoperative complications, and the visual outcome. Results: Three hundred twenty-two cases were considered high risk for PCR+VL. In this group, the PCR+VL rate was 5.3%; it was 3.7% in the low-risk group and 4.0% overall. Visual acuity of 6/9 or better was achieved by 76% of all eyes. Postoperative complications were 3 cases of endophthalmitis, 4 of retinal detachment, and 1 of pseudophakic bullous keratopathy. In 323 eyes, loose or broken sutures were removed and in 175, a neodymium:YAG capsulotomy was performed because of posterior capsule opacification. Conclusions: The incidence of perioperative and postoperative complications was comparable with those reported in other series. Factors that increased the risk of PCR+VL included pseudoexfoliation, diabetes mellitus, and a traumatic etiology. Previous glaucoma surgery and axial myopia of greater than 26.0 mm did not increase the PCR+VL risk. Loose or broken corneal sutures was a common finding that could be reduced substantially by planned suture removal.