Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Complications During Cataract Surgery, Management and Outcomes: Descriptive Research
Katarakt Cerrahisi Sırasında Gelişen Komplikasyonlar, Yönetimi ve Sonuçlarımız: Tanımlayıcı Araştırma
Mümin Enver YİĞİTa , Aysun SAGDANİa , Gökhan ÖZGEa , Ali Hakan DURUKANa , Önder AYYILDIZa , Duygu AKPINARa
aUniversity of Health Sciences Gülhane Faculty of Medical, Department of Ophthalmology, Ankara, Türkiye
Turkiye Klinikleri J Ophthalmol. 2024;33(4):252-7
doi: 10.5336/ophthal.2024-103827
Article Language: EN
Full Text
ABSTRACT
 Objective: In our study, we aimed to reveal the type of complication, the surgical stage at which it developed, and our outcomes in cases that underwent cataract surgery and experienced intraoperative complications. Material and Methods: A total of 8,806 cases that underwent phacoemulsification surgery at Ankara Gülhane Training and Research Hospital were retrospectively reviewed In complicated cases, data such as the type of cataract, additional case characteristics, surgical experience, type of anesthesia used, the stage at which the complication occurred, the necessity for vitreoretinal surgery, and the location and method of intraocular lens implantation (if implanted) were analyzed. Results: Of all cases, 64.6% (n=5,679) were operated on by faculty members, 22.9% (n=2,022) by specialist doctors, and 12.5% (n=1,105) by resident doctors. Intraoperative complications occurred in 289 (3.2%) of the phacoemulsification surgery cases. Among the complicated cases, 125 (43.4%) were performed by faculty members, 95 (32.8%) by specialist doctors, and 69 (23.8%) by resident doctors. The most common complication was posterior capsule rupture (75.7%).The most frequent stage at which complications occurred was the irrigationaspiration stage at 48.4%. Posterior capsule rupture was the most frequent complication, occurring in 76.1% (n=220) of cases.Vitreoretinalsurgery was performed in 32 of the 289 complicated cases. Visual acuity outcomes were better in cases completed in a single session compared to those requiring sequential surgeries (0.9 vs. 0.4, respectively, p<0.05). Conclusion: Our study provides valuable information on the stage at which complications most commonly occur during cataract surgery and the factors that affect the outcomes.

Keywords: Cataract; complications; phacoemulsification; posterior capsule rupture
ÖZET
 Amaç: Çalışmamızda, katarakt cerrahisi geçirmiş ve intraoperatif komplikasyon gelişmiş olgularda komplikasyonun şekli ve hangi cerrahi aşamada geliştiği ve sonuçlarımızı ortaya koymayı amaçladık. Gereç ve Yöntemler: Ankara Gülhane Eğitim ve Araştırma Hastanesi'nde fakoemülsifikasyon cerrahisi yapılan 8.806 olgu retrospektif olarak incelendi. Komplike olgularda katarakt tipi, ek olgu özellikleri, cerrahi deneyim, kullanılan anestezi türü, komplikasyonun hangi evrede ortaya çıktığı, vitreoretinal cerrahi gerekliliği, göz içi lens implantasyonunun (eğer implante edildiyse) yeri ve yöntemi gibi veriler incelendi. Bulgular: Tüm olguların %64,6'sı (n=5.679) öğretim üyeleri, %22,9'u (n=2.022) uzman doktor, %12,5'i (n=1.105) asistan doktor tarafından ameliyat edilmişti. Fakoemülsifikasyon cerrahisi yapılmış Olguların 289'unda (%3,2) intraoperatif komplikasyon geliştiği saptandı. Komplike olguların 125'i (%43,4) öğretim üyesi, 95'i (%32,8) uzman doktor, 69'u (%23,8) asistan doktor seviyesinde yapılan olgulardı. En sık görülen komplikasyon arka kapsül yırtılmasıydı (%75,7). Komplikasyonun en sık gerçekleştiği aşama %48,4 ile irrigasyon-aspirasyon aşamasıydı. En sık komplikasyon %76,1 (n=220) ile arka kapsül yırtılmasıydı. 289 komplike vakadan 32'sine VRC yapılmıştır. İlk seans ile bitirilen ameliyatların görme keskinlikleri sıralı ameliyat gerektiren olgulara göre daha iyi olarak saptandı (sırasıyla 0,9 ve 0,4, p<0,05). Sonuç: Çalışmamız katarakt ameliyatındaki komplikasyonların sıklıkla hangi aşamada gerçekleştiğini ve sonuçlara etki eden faktörler hakkında önemli bilgiler sunmaktadır.

Anahtar Kelimeler: Katarakt; komplikasyonlar; fakoemülsifikasyon; arka kapsül rüptürü
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