Posters

Analyzing the association between levels of cumulative dissipated energy, posterior capsular rupture and cataract grade during phacoemulsification

Poster Details

First Author: A. Bustamante COLOMBIA

Co Author(s):    R. Bechara                    

Abstract Details

Purpose:

To compare levels of cumulative dissipated energy (CDE) for the different grades of opacity of the lens, between the groups that had rupture of the posterior capsule and those that did not.

Setting:

Pilot, observational, descriptive, retrospective at the Department of Cataract of the Eye Clinic of Cartagena, Colombia

Methods:

All patients diagnosed with senile cataract were evaluated and classified using the LOCS III classification system. All patients were operated by the same surgeon, by conventional phacoemulsification, using the Constellation Vision System. The variables in the study included LOCS III classification, CDE and subsequent rupture of the lens capsule during the surgical procedure. For information processing a database in Excel was elaborated, and the statistical analysis was performed with Epi Info Version 7. The hypothesis was tested using the Mann-Whitney test to compare between groups and the p value of <0.05 was considered statistically significant.

Results:

Out of 228 patients, 110 patients met the inclusion criteria. 11 of which had posterior capsular rupture (PCR) . The median CDE in patients with PCR was 28.04, while those without PCR was 13.96, with p <0.0001. By comparing the amount of CDE with LOCS III classification criteria, stratified by the presence or absence of PCR, it was shown that in groups Nuclear3 (p <0,0011), Nuclear4 (p <0,0248), Corctical1 (p <0,0382), Cortical2 (p <0,0213), Cortical3 (p <0,0230) and PosteriorSubcapsular1 (p <0,0004) CDE values were statistically significantly higher in patients with PCR. Further analysis shown a progressive increase in CDE levels of both groups, with and without PCR, as the grade of nuclear opacity increased.

Conclusions:

CDE predispose a greater chance of PCR (p <0,0001). When groups were compared (with and without PCR), data showed statistical significance in the Nuclear3, Nuclear4, Cortical1, Cortical2, Cortical3 and PosteriorSubcapsular1, in which higher CDE were used when rupture occurred. In the other qualifying criteria, hypothesis testing could not be performed. Additionally, a correlation between increasing degree of nuclear opacity and increasing CDE were observed, which in turn, predisposes to PCR. Patients with high levels of CDE during surgery and higher grades of nuclear opacity before surgery, should be approached with greater caution by the surgeon.

Financial Disclosure:

NONE