Incidence of Intraoperative Complications During Phacoemulsification in Vitrectomized and Nonvitrectomized Eyes: Prospective Study

Purpose: To compare the incidence of intraoperative complications during phacoemulsification surgery in patients with and without prior pars plana vitrectomy (PPV).

Setting: Department of Ophthalmology, Norfolk, and Norwich University Hospital, Norwich, United Kingdom.

Methods: Prospective collection of operative complications in 2000 consecutive cataract extractions performed by 1 surgeon (R.L.B.). Details of all patients who had intraoperative complications including age at operation and sex were recorded. It was also noted whether the eye previously PPV. Complications recorded were posterior capsule rupture (PCR) with and without vitreous loss, iris trauma, loss of nuclear fragment into vitreous, and choroidal hemorrhage.

Results: Of 2000 eyes, 117 had previous PPV. Of these, there were 2 (1.70%) cases of PCR. There were no cases of iris trauma, choroidal hemorrhage, or dropped nucleus fragments into the posterior chamber. Nonvitrectomized eyes totaled 1883. Rates of complications were as follows: PCR without vitreous loss, 0.16%; PCR with vitreous loss, 0.53%; iris trauma, 0.16%; choroidal hemorrhage, 0.16%; and dropped nucleus fragment in the vitreous, 0.11%.

Conclusion: Despite well-known difficulties encountered in vitrectomized eyes such as zonular damage, increased mobility of the lens-iris diaphragm, and altered intraocular fluid dynamics, the incidence of intraoperative complication rates is similar to nonvitrectomized eyes in the hands of an experienced surgeon.