Posters

Results of cataract surgery and complex co-morbidities

Poster Details

First Author: E.Ansari UK

Co Author(s):                        

Abstract Details

Purpose:

To evaluate the success rate and complications of phacoemulsification in the presence of complex co-morbidities. We regularly audit our routine cataract surgery cases, but more and more cases are presenting with complex ocular and systemic co-morbidities. There is limited data on the success rate of such cases, but these should also be audited. Our study may form a benchmark for future audit of more complex cases.

Setting:

UK District General Hospital- Maidstone & Tunbridge Wells NHS Trust

Methods:

50 cases of day case phacoemulsification that were performed in eyes with additional ocular co-morbidites and/ or systemic co-morbidites were evaluated. The complexity of the procedure was classified according to a co-morbidity index. Phacoemulsification was performed under topical or subtenons anaesthesia in all cases. Post-operative medication was Dexamethasone 0.% qid and Nepafenc tid for 4 weeks. Eyes with a combined MIGS procedure were excluded. Paediatric cases were excluded. Case notes were reviewed. Pre and post operative best corrected visual acuity (BCVA), post-operative subjective refraction at 4 weeks, peri and post-operative complications were recorded. Additional return/ emergency visits were recorded.

Results:

There was a significant improvement in BCVA in all cases (p<0.05). BCVA improvement was less marked in cases with pre-existing maculopathy (p<0.05). Post-operative refraction was within 1D in 96% of cases. There was 1 case of posterior capsule rupture in a short eye (axial length 21mm). There was one case of post-operative cystoid macular oedema in 1 eye with diabetic retinopathy. 2 cases with primary angle closure had a prolonged recovery period of 6-8 weeks. There were no cases of endophthalmitis. BCVA improved in all cases, but was more marked in those without pre-existing maculopathy.

Conclusions:

BCVA improvement and low incidence of post-operative complications was found in this group of phacoemulsification cases with a diverse range of pre-existing ocular and systemic co-morbidities. Sub-analysis by co-morbidity showed a more significant improvement in BCVA in cases without maculopathy. However cases with maculopathy still had a significant improvement in BCVA. This study is being extended to include more cases with the aim for using the results to audit phacoemulsification cases with co-morbidities in the future. This study can be improved by including QoL measures.

Financial Disclosure:

None