Risk Factors for Posterior Capsule Rupture andVitreous Loss during Phacoemulsification

Purpose: To determine the rate and risk factors of vitreous loss during phacoemulsificationin patients with cataracts operated by ophthalmology residents and fellows atLabbafinejad Medical Center.Methods: This prospective descriptive study included consecutive patients withcataracts undergoing phacoemulsification over a one year period. All patients wereoperated under local or general anesthesia using the divide and conquer technique.Preoperatively, all patients underwent a complete ocular examination includingmeasurement of visual acuity, slitlamp biomicroscopy, intraocular pressure measurement,and dilated funduscopy. Main outcome measures included the rate of posteriorcapsular rupture and vitreous loss as well as associated risk factors such assurgical experience, ocular and systemic conditions, and type and severity of thecataract.Results: Overall, 767 eyes of 767 patients with mean age of 63.7±10.3 (range, 25-91)years were operated. The overall rate of vitreous loss was 7.9% which was 5-fold greaterin the hands of residents as compared to fellows. Among different factors, older age,female sex, small pupil, small capsulorrhexis, presence of pseudoexfoliation, and highmyopia were significantly associated with vitreous loss. The highest rate of vitreous lossoccurred in patients with dense nuclear cataracts.Conclusion: Considering the higher rate of vitreous loss in patients operated byophthalmology residents; patients with known risk factors for vitreous loss shouldbetter be operated by more experienced surgeons.