INTRA- AND EARLY POSTOPERATIVE COMPLICATIONS IN PHACOEMULSIFICATION CATARACT SURGERY AT HIPPOKRATEIO GENERAL HOSPITAL OF THESSALONIKI: A RETROSPECTIVE CHART REVIEW OF 9847 CASES

To present the frequency of intraoperative and early postoperative complications related to phacoemulsification cataract extraction that were recorded at Hippokrateio General Hospital of Thessaloniki during an 8-year period.

Department of Ophthalmology, Hippokrateio General Hospital of Thessaloniki, Thessaloniki, Greece

A retrospective chart review of 9847 cases who underwent cataract surgery by phacoemulsification in the last eight years at Hippokrateio General Hospital of Thessaloniki was performed. Details of intraoperative (posterior capsular rupture, vitreous loss, dropped nucleus/lens matter, zonular detachment) and early postoperative complications (IOL dislocation, ocular hypertension, Toxic Anterior Segment Syndrome, endophthalmitis) were recorded.

9847 cataract surgeries were performed via phacoemulsification. 23% of all eyes were considered high-risk due to brunescent/intumescent cataract, pseudoexfoliation, small pupil and/or Intraoperative Floppy Iris Syndrome (IFIS). Posterior capsular rupture was observed at 374 cases (3,8%), vitreous loss due to posterior capsular rupture or zonular detachment was observed at 256 cases (2,6%) and dropped nucleus/lens matter was observed at 35 cases (0,36%) intraoperatively.  Postoperatively, IOL dislocation was observed at 64 cases  (0,65%), luxation of IOL into the posterior segment was observed at 29 cases (0,3%) and endophthalmitis was observed at 1 case (o,o1%). Those complications were successfully treated with either anterior or 23G pars plana vitrectomy followed by sulcus IOL placement, while transscleral or sutureless intrascleral IOL fixation was performed in case of insufficient zonular or capsular support. Toxic Anterior Segment Syndrome (TASS) was noted in 9 cases (0,1%) and short term ocular hypertension in 69 cases (0,7%) , both effectively treated conservatively. 

The rate of intra- and early postoperative complications, which were successfully treated in our department, agrees with internationally reported data despite the significant number of high-risk cases.