Risk factors for posterior capsule rupture in cataract surgery as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery

Segers, Maartje HM and Behndig, Anders and van den Biggelaar, Frank JHM and Brocato, Lucia and Henry, Ype and Nuijts, Rudy MMA and Rosen, Paul and Tassignon, Marie-José and Young, David and Stenevi, Ulf and Lundström, Mats and Dickman, Mor M (2021) Risk factors for posterior capsule rupture in cataract surgery as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery. Journal of Cataract and Refractive Surgery. ISSN 0886-3350 (https://doi.org/10.1097/j.jcrs.0000000000000708)

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Abstract

PURPOSE: To analyze the incidence and risk factors of posterior capsule rupture (PCR) in cataract surgery. SETTING: European clinics affiliated with the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO). DESIGN: Retrospective cross-sectional register-based study. METHODS: Data was obtained from the EUREQUO. The database contains data on demographics, comorbidities, and intraoperative complications, including PCR for the study period from January 1, 2008, to December 31, 2018. Univariable and multivariable logistic regression analyses were performed to estimate the (adjusted) odds ratio (OR) and 95% confidence intervals (CI). RESULTS: Data was available of 2,853,376 patients and 31,749 (1.1%) cataract surgeries were complicated by a PCR. The PCR rate ranged from 0.60 to 1.65 percent throughout the years, with a decreasing trend (p <0.001). The mean age of the PCR cohort was 74.8 ± 10.5 years and 17,629 (55.5%) patients were female. Risk factors most significantly associated with PCR were corneal opacities (OR 3.21, 95% CI 3.02 – 3.41, p <0.001), diabetic retinopathy (OR 2.74, 95% CI 2.59 – 2.90, p <0.001), poor preoperative visual acuity (OR 1.98, 95% CI 1.88 – 2.07, p <0.001), and white cataract (OR 1.87, 95% CI 1.72 – 2.03, p <0.001). CONCLUSION: Risk factors for PCR were identified based on the EUREQUO and the incidence of this complication is decreasing over time. Corresponding author: Mor M. Dickman, University Eye Clinic Maastricht, Maastricht University Medical Center, PO Box 5800, 6202 AZ, Maastricht, the Netherlands. Email: mor.dickman@mumc.nl Received February 06, 2021 Received in revised form May 19, 2021 Accepted May 26, 2021 © 2021 Published by Wolters Kluwer on behalf of ASCRS and ESCRS

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