Patient Age And Posterior Capsule Rupture Risk In Phacoemulsification Cataract Surgery

Posterior capsule rupture (PCR) during phacoemulsification cataract surgery has been shown to worsen outcomes and increase the number of postoperative complications. With an ageing population, it is valuable to analyse real world associations between patient age and the risk of this complication in large cohorts of patients.

Retrospecitve analysis in a major multi-site National Health Service Trust in the United Kingdom

We retrospectively examined all the phacoemulsification cataract surgeries at Moorfields Eye Hospital National Health Service Trust and its outreach sites over a period between September 2012 to December 2022. Cases were identified by an automated search of the electronic patient record system used to record all surgery. Cases were excluded when another planned intraocular procedure was conducted at the same time as the phacoemulsification cataract surgery. Statistical analysis between groups was conducted with the Chi-Squared test with Pearson correction.

Significantly increased risk of PCR below 60 years of age (Odds ratio 0.87; P-Value 0.022)

Significantly increased risk of PCR above 80 years of age (Odds ratio 1.15; P-Value 0.007).

Increasing age has been identified as a risk factor for PCR; with numerous potential causes suggested such as increased lens density, weaker zonules, smaller pupils and poorer visualisation due to an ageing cornea. The finding of a statistically significant increased risk of having a PCR below 60 years of age is rather more interesting. The cause for this finding is unclear and largely open to debate. It is possible that there were a greater number of more complex cases in this age group; such as posterior polar and uveitic cataracts.