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Cataract surgery in elderly and very elderly adults: is it worth performing?
Poster Details
First Author: A.Michonidou GREECE
Co Author(s): O. Sideri E. Tsirampidou D. Balatsoukas E. Kanonidou
Abstract Details
Purpose:
The aim of this study was to present the outcomes of cataract surgery in elderly and very elderly patients at our department, during a period of 18 months, taking into consideration the special issues concerning this sensitive population.
Setting:
Ophthalmology Department, Hippokrateion General Hospital of Thessaloniki, Greece
Methods:
We performed a retrospective chart review of 744 patients, older than 80 years of age who underwent cataract removal surgery either by phacoemulsification or by extracapsular cataract extraction (ECCE) between January 2017 and June 2018. Intraoperative complications were recorded and patient history data for risk factors {pseudoexfoliation (PEX), poorly dilating pupil, intraoperative floppy iris syndrome (IFIS), hypermature-white cataract with visual acuity less than 6/60} were collected by retrospective review of their medical records.
Results:
Intraoperative complications occurred in 89 (11,9%) patients (61 aged 80-84, 19 85-89 and 9 ≥ 90 years). Out of the 89 complicated cases, 76 underwent phacoemulsification, 4 ECCE and 9 phaco converted to ECCE. Posterior lens capsule rupture (PLC) occured in 66 cases (8,9%), followed by vitreous loss in 29 (3,9%). Posterior loss of lens fragments affected 7 eyes (0,9%), posterior dislocation of IOL 2 (0,2%) and suprachoroidal haemorrage 5 eyes (0,7%). 44 of the complicated cases concerned hypermature cataracts with preoperative visual acuity less than 6/60, 35 poorly dilating pupils, 27 eyes with PEX and 22 with IFIS.
Conclusions:
High prevalence of systemic comorbidities (diabetes mellitus, hypertension, benign prostatic hyperplasia treated with alpha blockers, anticoagulant therapy) leading to high risk eyes resulted in a relatively high rate of intraoperative complications. However cataract surgery was successful in the great majority of our elderly patients, concluding that, yes, cataract surgery is worth being performed even on patients above 80 year.
Financial Disclosure:
None