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Intraoperative complications during phacoemulsification in patients with systemic Alpha-1 blockers

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Session Details

Session Title: Presented Poster Session: Cataract Complications Management

Venue: Poster Village: Pod 1

First Author: : T.Fredriksson SWEDEN

Co Author(s): :    M. Zetterberg              

Abstract Details

Purpose:

To evaluate complications occurring during cataract surgery in patients with a history of systemic Alpha-1 blocker use.

Setting:

Department of Ophthalmology, Sahlgrenska University Hospital, Sweden.

Methods:

A total of 1729 patients were included in a retrospective study. Data was collected on age, gender and use of Alpha-1 blockers. Also, preoperative data on pupil diameter and pseudoexfoliations (PEX) were retrieved, as well as intraoperative adverse events, such as pupillary constriction, iris billowing, iris prolapse and posterior capsule rupture.

Results:

Using logistic binary regression including age, PEX and use of Alpha-1 blockers were significantly associated with smaller pupils; adjusted Odds ratio [aOR] for Alpha-1 blockers was 2.61 (95% CI 1.52-4.47, p<0.001) and for PEX aOR 2.54 (95% CI 1.71-3.79, p<0.000). PEX and age were associated with mechanical pupil dilation; aOR 5.02 (95% CI 2.82-8.95, p<0.000) and aOR 1.08 (95% CI 1.05-1.12, p<0.000) respectively. No significant associations were seen between Alpha-1 blocker use or PEX and iris billowing or iris prolapse. Age was the only significant risk factor for posterior capsule rupture 1.08 (95% CI 1.02-1.13, p=0.004).

Conclusions:

Both alpha-1 blockers and PEX were associated with smaller pupils preoperatively but only PEX was associated with mechanical pupil dilation, indicating that PEX is a stronger risk factor for intraoperative pupil constriction than alpha-1 blockers. However, neither alpha-1 blockers nor PEX resulted in more intraoperative complications. High age was associated with both mechanical pupil dilation and posterior capsule rupture.

Financial Disclosure:

NONE

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