Variation and predictors of complications of cataract surgery' results from the agfa cataract outcomfs measurement project

R. M. Schiffman, J. Javitt, R. Baske, A. B. Willerscheidi, C. Burns, L. Brown, R. S. Pasiora, G. Pugsley, L. D. Wood, T. Loehr, E. Weyer, R. W. McCarthy, A. L. Muhich, G. Jacobsen

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose. In 1993, the American Group Practice Association (AGPA) embarked on a large-scale prospective cataract outcomes measurement project designed to measure changes in. I ) visual acuity, 2) complication rates; 3) visual functioning; ana 4) overall health status in patients undergoing cataract extraction. This report examines complications of cataract surgery in patients undergoing first eye surgery. Methods, Patients undergoing cataract extraction alone by one of 30 senior surgeons at each of 6 large group practices were enrolled in this project. Clinical and outcomes information was obtained preoperatively, immediately postoperatively and 3-9 months following surgery. Overall intraoperative and postoperative complication rates were computed as well as complication rates by clinic site and by surgeon, Multivariate analyses were performed to adjust for age, race, gender, education, medical and ocular comorbidity, site and surgeon. Results. To date, 3,433 patients have been enrolled in the study and undergone first eye surgery. 62.5% were female and 3.8% were African-Americans. The average age was 72.1 yrs. 63.7% of the surgeries were done by phaco and 36.3% were done by ECCE. 82.7% of the lOLs were nonfoldable PCLs and 14.9% were foldable PCLs. 91.4% of these patients experienced an improvement in visual acuity For intraoperative events, broken capsules (BROK) were reported in 3,4% of surgeries, vitreous loss (VIT) in 2.6%, zonular dehiscence (ZON) in 1.4%, nuclear loss (NUC) in 0.29% and choroidal hemorrhage in 0.13%. Postoperative events included Yag capsulotomy ( YAG) in 8 7% of cases, CME in 1.6% of cases and endophthalmitis in 0.06%. Blacks experienced a higher rate of ZON than Caucasians (6.1% vs. 1.2%, p; NUC (range: 0-5.9%, p=.002) and YAG (range: 0-52.6%, p=.001). When analyzed by multivariale techniques, site and surgeon were significant in predicting differences in rates for all events except CME (p

Original languageEnglish (US)
JournalInvestigative Ophthalmology and Visual Science
Volume38
Issue number4
StatePublished - 1997
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology

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