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The Malaysian Cataract Surgery Registry: risk Indicators for posterior capsular rupture
  1. Mohamad Aziz Salowi1,2,
  2. Fiona L M Chew3,
  3. Tassha Hilda Adnan4,
  4. Christopher King5,
  5. Mariam Ismail6,
  6. Pik-Pin Goh7
  1. 1Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
  2. 2Department of Ophthalmology, Hospital Selayang, Batu Caves, Malaysia
  3. 3Department of Ophthalmology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
  4. 4Biostatistics Unit, National Clinical Research Centre, Kuala Lumpur, Malaysia
  5. 5Buckinghamshire Healthcare NHS Trust, UK
  6. 6Department of Ophthalmology, Sultan Abdul Halim Hospital, Sungai Petani, Kedah, Malaysia
  7. 7Clinical Research Centre, National Clinical Research Centre, Kuala Lumpur, Malaysia
  1. Correspondence to Dr Fiona L M Chew, Department of Ophthalmology, Kuala Lumpur Hospital, Department of Ophthalmology, Kuala Lumpur Hospital, Jalan Pahang, Kuala Lumpur, 50586 Malaysia; sabrefmin{at}


Aim To identify the risk indicators for posterior capsular rupture (PCR) in the Malaysian Cataract Surgery Registry (CSR).

Methods Data from the web-based CSR were collected for cataract surgery performed from 2008 to 2013. Data was contributed by 36 Malaysian Ministry of Health public hospitals. Information on patient's age, ethnicity, cause of cataract, ocular and systemic comorbidity, type of cataract surgery performed, local anaesthesia and surgeon's status was noted. Combined procedures and type of hospital admission were recorded. PCR risk indicators were identified using logistic regression analysis to produce adjusted OR for the variables of interest.

Results A total of 150 213 cataract operations were registered with an overall PCR rate of 3.2%. Risk indicators for PCR from multiple logistic regression were advancing age, male gender (95% CI 1.04 to 1.17; OR 1.11), pseudoexfoliation (95% CI 1.02 to 1.82; OR 1.36), phacomorphic lens (95% CI 1.25 to 3.06; OR 1.96), diabetes mellitus (95% CI 1.13 to 1.29; OR 1.20) and renal failure (95% CI 1.09 to 1.55; OR 1.30). Surgical PCR risk factors were combined vitreoretinal surgery (95% CI 2.29 to 3.63; OR 2.88) and less experienced cataract surgeons. Extracapsular cataract extraction (95% CI 0.76 to 0.91; OR 0.83) and kinetic anaesthesia were associated with lower PCR rates.

Conclusions This study was agreed with other studies for the risk factors of PCR with the exception of local anaesthesia given and type of cataract surgery. Better identification of high-risk patients for PCR decreases intraoperative complications and improves cataract surgical outcomes.

  • Treatment Surgery

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  • Correction notice This article has been corrected since it was published Online First. The Acknowledgements section has been updated and a second affiliation has been added to the first author.

  • Contributors Conception and design of the study (MAS, PPG, MI); analysis and interpretation (MAS, PPG, THA, FLMC, MI); writing of the article (MAS, PPG, THA, FLMC, MI); critical revision of the article (MAS, PPG, THA, FLMC, MI); final approval of the article (MAS, PPG, THA, FLMC, MI); data collection (MAS, PPG, MI); obtaining funding (MAS, PPG, MI); literature search (MAS, PPG, FLMC); administrative, technical or logistic support (MAS, PPG, THA, FLCM, MI).

  • Funding This study was supported by a grant from the Malaysian Ministry of Health Research Grant.

  • Competing interests None declared.

  • Ethics approval Ethical approval was obtained from the Medical Research and Ethics Committee of the Malaysian Ministry of Health.

  • Provenance and peer review Not commissioned; externally peer reviewed

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