Eleven year review of risk factors and visual outcomes of patients with posterior capsule rupture (PCR) as a complication of cataract surgery at a district general hospital

Abstract

PurposeTo report risk factors and visual outcomes of cataract surgery complicated by posterior capsule rupture (PCR) at Portsmouth Hospital over an 11 year period (2004–2015)MethodsA search of all cataract surgery complicated by PCR was performed on our Electronic Patient Record (EPR). Clinical data was extracted from the EPR, patient case notes and clinical letters. Only patients with a minimum of 3 months VA recorded were included.ResultsIn total 366 patients were identified. The mean number of cataract operations performed per year was 3,832 giving an overall PCR rate of 0.98%. Of the cases affected the average age was 74 years and 56% were female. The most common risk factors were dense cataract (15%), high myopia (8%) and previous vitrectomy (6%). Thirty five percent of PCR cases occurred during a trainee surgical list. Initial mean best corrected VA in all patients was 0.68, 0.62 at 3 months and 0.46 at 1 year. The mean length of follow up was 35 months and the mean VA was 0.36 at the final visit.ConclusionsPCR rate at Portsmouth is almost half the national rate. We found in our cohort of patients, previous vitrectomy was a common risk factor which was not reflected in the Royal College of Ophthalmologists’ National Database. Over a third of PCR occurred during trainee lists, emphasising the need for risk stratification preoperatively to identify difficult cases.