Causes of Suboptimal Corrected Visual Acuity following Phacoemulsification in a Teaching University Hospital

Fathallah, Mohammed; Eltanamly, Rasha M; Saadeldin, Hala; Elnahry, Gehad H.

doi:10.5301/ejo.5000824

Cited by 4 publications

(6 citation statements)

References 6 publications

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“…Less experienced surgeons have been identified as a considerable risk factor for PCR. Fathallah et al 4 described an incidence of PCR as high as 23.3%. In their study, >40% of surgeons were junior staff who disproportionally contributed to the complication rate.…”

Section: Discussionmentioning

confidence: 99%

“… 1 , 2 The published incidence of posterior capsular rupture (PCR) varies considerably within the literature from 0.18% to 23.3%. 3 , 4 Ocular risk factors include miosis, zonulopathy, axial length, previous surgery and concurrent ocular procedures. 5 , 6 The learning curve remains a further variable with studies indicating an increased incidence among inexperienced surgeons or those surgeons with relatively lower surgical volumes.…”

Section: Introductionmentioning

confidence: 99%

“… 5 , 6 The learning curve remains a further variable with studies indicating an increased incidence among inexperienced surgeons or those surgeons with relatively lower surgical volumes. 4 , 7 – 9 …”

Section: Introductionmentioning

confidence: 99%

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Posterior capsular complication rates with femtosecond laser-assisted cataract surgery: a consecutive comparative cohort and literature review

Levitz¹,

Reich²,

Hodge³

2018

OPTH

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PurposeThe aim of the study was to determine whether femtosecond-assisted laser cataract surgery (FLACS) reduces the posterior capsular complication (PCC) rate compared to manual cataract surgery when performed by an experienced surgeon.Patients and methodsWe reviewed 2,021 consecutive FLACS procedures between 1 June 2012 and 30 August 2017. All cases of posterior capsular rupture (PCR) with or without vitreous prolapse or zonular dialysis (ZD) that prevented an in-the-bag placement of the intraocular lens were included. Risk factors were noted and outcomes documented.ResultsSix eyes of 2,021 (0.3%) who underwent FLACS had either a PCR or ZD. One eye (0.25%) of 403 eyes that had manual cataract surgery had a PCR. There was no significant difference in outcomes. Risk factors included advanced age, dense nuclei, pseudoexfoliation and small pupil. Only a single case in the FLACS series may have been directly attributed to the FLACS procedure.ConclusionThis study provides evidence that there is no significant difference in the PCC rate between FLACS and manual cataract surgery in the hand of an experienced surgeon who performs >350 cases annually. This low rate of complications may be achieved by less experienced surgeons adopting FLACS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Posterior capsular complication rates with femtosecond laser-assisted cataract surgery: a consecutive comparative cohort and literature review

Levitz¹,

Reich²,

Hodge³

2018

OPTH

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“…The rate of surgical complications was similar in this and prior studies. (6,7,25,26) This study has some limitations. Overall, 22.1% of patients were lost to follow-up.…”

Section: Discussionmentioning

confidence: 96%

Impact of cataract surgery on visual acuity and quality of life assessed using the National Eye Institute Visual Function Questionnaire 25 in a public teaching hospital in Brazil

Koch¹,

Neves²,

Paredes³

et al. 2022

Revista Brasileira De Oftalmologia

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Purpose: This study set out to examine the impact of surgical treatment of senile cataract on visual acuity and quality of life in patients operated in a public teaching hospital.Methods: Prospective study including patients aged over 60 years with clinical indications for cataract surgery treated at a medical residency service. The National Eye Institute Visual Function Questionnaire 25 was applied. Corrected distance visual acuity was measured before and after cataract surgery. Correlations between National Eye Institute Visual Function Questionnaire 25 scores and corrected distance visual acuity were investigated. Surgeons in charge, and surgical complications were also reported.Results: A total of 69 patients (89 eyes) were enrolled in this study. Patients were submitted to unilateral (52) or bilateral (17) surgery. Mean patient age was 70.8 ± 7.3 (52 to 95) years. Mean preoperative and postoperative National Eye Institute Visual Function Questionnaire 25 scores were 77.4 ± 15.3 (25.7 to 98.2) and 89.7 ± 14.0 (28.2 to 100) respectively. The larger differences in National Eye Institute Visual Function Questionnaire 25 subscale scores were associated with general vision (from 34.4 to 48.6). Mean preoperative and postoperative corrected distance visual acuity were 0.7 ± 0.39 (0.3 to 1.3) LogMAR and 0.24 ± 0.19 (0.1 to 1.0) LogMAR respectively. Comparative analysis of preoperative and postoperative findings revealed significant (p<0.001) improvements in quality of life and corrected distance visual acuity. Most surgeries (70%, 74 eyes) were performed by surgeons in training. Comparative analysis between patients submitted to unilateral and bilateral surgery revealed significantly (p=0.016) larger visual acuity gains in patients requiring surgery in both eyes. However, questionnaire scores did not differ significantly (p=2.48). Complications were observed in 13 eyes (14.6%), posterior capsule tear being the most common. Even in these cases, total National Eye Institute Visual Function Questionnaire 25 scores and corrected distance visual acuity increased significantly (p<0.001). Conclusion:Cataract surgery performed in teaching hospital settings improved patient quality of life and visual acuity. Therefore, public health agencies should ensure access to cataract surgery.

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“…Wet Labs provide a safe, risk-free, and less stressful environment, which offers to trainees the opportunity, inter alia, to gain self-confidence, to try various methods and techniques and select the most appropriate for their convenience, to improve psycho-motor skills, coordination between hands and eyes, as well as ambidextrously, to discuss their questions without time pressure, and learn from their mistakes, without any cost, even learn how to manage possible complications [ 12 ]. The high complication rate is attributed to the nature of the teaching hospital where most trainees were in their learning periods [ 13 ]. These complications may have an essentially functional and financial impact [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

The contribution of wet labs in the education of ophthalmologists

Almaliotis

Athanasopoulos

Almpanidou

et al. 2021

Annals of Medicine and Surgery

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Causes of Suboptimal Corrected Visual Acuity following Phacoemulsification in a Teaching University Hospital

Abstract: Kasr Al Ainy Hospital achieved CVA 6/9 or more in 69.3% and CVA 6/18 or more in 81.3% of patients. The capsular complication rate was high at 23.3%. The high complication rate is attributed to the nature of the teaching hospital where most surgeons were in their learning periods.

Cited by 4 publications

References 6 publications

Posterior capsular complication rates with femtosecond laser-assisted cataract surgery: a consecutive comparative cohort and literature review

Posterior capsular complication rates with femtosecond laser-assisted cataract surgery: a consecutive comparative cohort and literature review

Impact of cataract surgery on visual acuity and quality of life assessed using the National Eye Institute Visual Function Questionnaire 25 in a public teaching hospital in Brazil

The contribution of wet labs in the education of ophthalmologists

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