Wydanie 3/2004

Ocena powikłań śródoperacyjnych i wczesnych powikłań pooperacyjnych fakoemulsyfikacji zaćmy - badanie 1000 przypadków

Evaluation of intraoperative and early postoperative complications of phacoemulsification - a study of 1000 cases

Beata Latecka-Krajewska, Michał Wilczyński, Hanna Grymin, Olena Wilczyńska, Aleksandra Synder, Wojciech Omulecki

Klinika Chorób Oczu Uniwersytetu Medycznego w Łodzi Kierownik: dr hab. n. med. Wojciech Omulecki


Summary: Purpose: Retrospective analysis intraoperative and early postoperative complications of phacoemulsification. Material and methods: The examined group consisted of 930 patients (1000 eyes), including 578 women (62.15%) and 352 men (37.85%), aged 21 to 94 years (mean age 69.45 years, SD ? 12.18). Data were gathered from case histories of patients who underwent cataract extraction by phacoemulsification from June 2002 until June 2003 in the Department of Ophthalmology, Medical University of Łódź. The evaluated data included: pre- and postoperative best corrected visual acuity on day 1 and 7, intraocular pressure, pre- and postoperative condition of eye anterior and posterior segment and the occurence of intraoperative and early postoperative complications. Results: In the majority of patients there were no intraoperative and early postoperative complications present. Intraoperative complications were present in 66 eyes (6.6%), early postoperative complications ? in 238 eyes (23.8%). The most frequent intraoperative complication was posterior capsular rupture (52 eyes, 5.2%). In 12 eyes from this group anterior vitrectomy was performed. In 4 eyes (0.4%) the iris was injured by the phacoemulsificator tip, there was a considerable intraoperative pupil constriction in 2 eyes (0.2%), a dropped fragments of the nucleus in 3 eyes (0.3%) and a vitreous haemorrhage in 1 eye (0.1%). The most frequent early postoperative complications were: Descemet folds (111 eyes, 11.1%) and temporary corneal edema (77 eyes, 7.7%). There was a IOL dislocation in 5 eyes (0.5%), in 2 eyes of this group the intraocular lens was subsequently repositioned. Two eyes (0.2%) developed endophthalmitis, in 18 eyes (1.8%) there was a transient rise in intraocular pressure, and in 7 eyes (0.7%) there was a trace of blood in the anterior chamber. Conclusions: Phacoemulsification, a contemporary standard in cataract surgery, is a safe and effective procedure. The majority of patients present no intraoperative complications. A higher percentage of patients has early postoperative complications, however, most of them are temporary and do not significantly influence the final outcome of the procedure.

Keywords: phacoemulsification, complications.


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