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Risk model for intraoperative complication during cataract surgery based on data from 900 000 eyes: previous intravitreal injection is a risk factor
  1. Poya Hård af Segerstad
  1. Dept of Clinical Sciences Lund, Ophthalmology, Lund University, Skåne University Hospital, Lund, Sweden
  1. Correspondence to Dr Poya Hård af Segerstad, Skåne University Hospital, Klinikg 18, Lund, Sweden; p.res{at}hardaf.se

Abstract

Background/aims The aim of this study was to develop a risk model for intraoperative complication (IC) during cataract surgery, defined as posterior capsule rupture and/or zonular dehiscence, and to include previous intravitreal therapy (pIVT) in the model.

Methods This retrospective register-based study covered patients reported to the Swedish National Cataract Register (SNCR) between 1 January 2010 and 30 June 2018. Odds ratios (ORs) were used to quantify association strength of each variable with IC. Data from the SNCR were cross referenced with the Swedish Macula Register to include data on pIVT. Variables statistically significant in the univariate analyses (p<0.05) were included in a multivariate logistic regression model.

Results The inclusion criteria were met by 907 499 eyes. The overall rate of IC was 0.86%. Variables significantly associated with IC were best corrected visual acuity ≥1.0 LogMAR (OR (adjusted): 1.75, p<0.001), age ≥90 years (OR: 1.25, p<0.001), male sex (OR: 1.09, p<0.01), pseudoexfoliation (OR: 1.33, p<0.001), glaucoma (OR: 1.11, p<0.05), diabetic retinopathy (OR: 1.35, p<0.001), pIVT (OR: 1.45, p<0.05), surgeon’s experience <600 surgeries (OR: 2.77, p<0.001), use of rhexis hooks (OR: 6.14, p<0.001), blue staining (OR: 1.87, p<0.001) and mechanical pupil dilation (OR: 1.52, p<0.001).

Conclusion The risk model can be used in the preoperative setting to predict the probability of IC, to facilitate planning of surgery and improving patient communication. Patients who have undergone intravitreal therapy prior to cataract surgery have an increased risk of IC during cataract surgery.

  • lens and zonules
  • epidemiology
  • macula

Data availability statement

The deidentified patient data used in this article are not publicly available and may be obtained from the Swedish National Cataract Register (www.kataraktreg.se) and the Swedish Macula Register (www.makulareg.se), given approval from the appropriate Swedish authorities.

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Data availability statement

The deidentified patient data used in this article are not publicly available and may be obtained from the Swedish National Cataract Register (www.kataraktreg.se) and the Swedish Macula Register (www.makulareg.se), given approval from the appropriate Swedish authorities.

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Footnotes

  • Contributors Concept, design, statistical analysis, interpretation of data and manuscript writing was performed by PHaS.

  • Funding This study was partly supported by the Foundation for Visually Impaired in former Malmöhus Län (180414), The Eye Foundation (Ögonfonden (190426)) and The Cronqvist Foundation (SLS-879931). The funding organisations had no role in the design nor conduct of this research.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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