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Wound leak following phacoemulsification surgery

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Session Details

Session Title: Presented Poster Session: Complications Management in Cataract Surgery

Venue: Poster Village: Pod 1

First Author: : C.Pisarek UK

Co Author(s): :    N. Mandal   V. Saw           

Abstract Details

Purpose:

Postoperative wound leak is a rare but serious complication of phacoemulsification surgery. Wound leak is associated with poor vision, a shallow anterior chamber and low intraocular pressures. If left untreated, it can lead to infection and astigmatism. In this study we evaluated the incidence and factors associated with wound leak following non- torsional phacoemulsification surgery in a tertiary teaching hospital.

Setting:

Imperial College Healthcare NHS Trust, London, UK

Methods:

Retrospective series of cases of postoperative wound leak following non-torsional phacoemulsification surgery at Imperial College NHS Trust between 2011-2014. Data was collected regarding complexity of the surgical case, age of patient, grade of surgeon, type of wound construction, postoperative refraction and visual outcome. Descriptive analysis was performed.

Results:

14 cases(7 female, 7 male). Incidence of wound leak was 0.09% (14/14,800). All patients were aged over 60. 50% of wound leaks occurred in patients aged over 80. Trainee surgeons were responsible for 86% of wound leak cases. Wound burn was documented in 28%. Ocular characteristics included: brunescent cataract 36%, glaucoma 50%, narrow angles & hypermetropia 14%. 2.75mm corneal incision used in all cases, 73% being 3-plane wounds. Incision location was temporal in 83%. In 28% of cases, surgery was complicated by posterior capsule rupture. Postoperative refractive astigmatism >2D was recorded in 44%, but this resolved following suture removal.

Conclusions:

Wound leak following cataract surgery is uncommon. Using torsional phacoemulsification for brunescent cataracts could reduce the incidence of wound burn by reducing the amount of ultrasound energy used. Suturing clear corneal temporal wounds in cases of wound burn, posterior capsule rupture, narrow angles and floppy iris, particularly those carried out by trainee surgeons, should be considered

Financial Disclosure:

NONE

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