MAR 20, 2014
This five-year audit of cataract surgeries at a single center found that although posterior capsule rupture was more common with residents, overall visual outcomes were similar to those of faculty.
They reviewed all cases of cataract surgery-related posterior capsule rupture occurring between 2006 and 2010 at The Singapore National Eye Centre.
There were 887 capsule ruptures in 48,377 surgeries, for an overall capsule rupture rate of 1.8 percent. Uneventful cases had significantly better visual outcomes than capsule ruptures.
Visual outcomes were similar between faculty- and resident-conducted surgeries despite the higher rupture rates for residents – 3.4 percent versus 1.4 percent. The authors attribute this to careful supervision of residents during surgery, postoperative care and the case mix itself.
Ruptures most frequently occurred during phacoemulsification (59.6 percent) and irrigation and aspiration (24.8 percent). However, the stage of surgery in which capsule ruptures occurred did not impact outcomes.
Significant risk factors for poor visual outcomes of capsule ruptures included age > 65 years, dropped nuclei and additional complications, such as retinal detachment, vitreous hemorrhage, corneal decompensation and intraocular implant dislocation.