Purpose
To identify risk factors for intraoperative vitreous complications in resident-performed phacoemulsification surgery
Setting
2 urban public county hospitals
Methods
A retrospective review of phacoemulsification cataract surgeries performed by residents between January 4, 2005, and January 8, 2008
Results
Of 2434 cases meeting inclusion criteria there were 92 vitreous complications (3.8%). Significant preoperative risk factors for vitreous complications on univariate analysis included older age (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01–1.05; P=0.020), worse preoperative best corrected visual acuity (BCVA) (OR, 1.5; 95% CI, 1.1–2.0; P=0.007), left eye (OR, 1.6; 95% CI, 1.0–2.4; P=0.043), history of trauma (OR, 1.8; 95% CI, 1.0–3.4; P=0.045), prior pars plana vitrectomy (OR, 2.3; 95% CI, 1.0–5.0; P=0.034), dementia (OR, 4.4; 95% CI, 1.5–12.9; P=0.020), phacodonesis (OR, 7.1; 95% CI 2.0–26.1; P=0.014), zonular dehiscence (OR, 8.8; 95% CI 4.2–18.5; P<0.0001), posterior polar cataract (OR, 7.7; 95% CI 1.6–37.2; P=0.037), white/mature cataract (OR, 2.0; 95% CI, 1.2–3.5; P=0.005), dense nuclear sclerotic cataract (OR, 2.4; 95% CI, 1.5–4.0; P=0.0006), and poor red reflex (OR, 1.9; 95% CI, 1.2–2.9; P=0.002). Factors that remained significant on multivariate analysis were older age (OR, 1.03; 95% CI, 1.01–1.05), worse preoperative BCVA (OR, 1.52; 95% CI 1.14–2.03), left eye (OR, 1.63; 95% CI, 1.05–2.51), prior pars plana vitrectomy (OR, 1.88; 95% CI 1.01–3.51), dementia (OR, 3.65; 95% CI, 1.20–11.17), and zonular dehiscence (OR, 8.55; 95% CI, 3.92–18.63).
Conclusions
Elements of the preoperative history and exam can identify patients at higher risk for intraoperative complications during resident-performed phacoemulsification surgery.
