Journal List > J Korean Ophthalmol Soc > v.57(6) > 1010605

Park, Kim, Choi, Kim, and Park: Clinical Results after Phacoemulsification in Mature Cataract

Abstract

Purpose

To evaluate the clinical results after phacoemulsification in mature and immature cataracts.

Methods

Mature cataract was defined as a classification of C5 by Lens Opacities Classification System III compared with other types of cataracts as controls. The present study included 37 (37 eyes) patients diagnosed with mature cataracts that received phacoemulsification and were followed up for at least 1 year. Thirty-seven (37 eyes) patients with other types of cataracts were selected randomly as controls. Intraoperative factors and rate of complications during and after surgery were evaluated. Best corrected visual acuity (BCVA), corneal endothelial cell density and central macular thickness (CMT) were measured during the 1 year of follow-up and compared with the controls.

Results

Twenty-seven eyes (mature cataracts) and 36 eyes (controls) received a complete continuous curvilinear capsulorhexis (CCC). The success rate of complete CCC was significantly high in the control eyes (p = 0.025). However, in mature cataract patients, 3 cases of posterior capsule rupture occurred among the 6 cases of radial tear of the anterior capsule, resulting in implantation of the lens in the sulcus. Posterior capsular ruptures were observed in 4 patients with mature cataracts and in 1 control with no statistically significant difference in the occurrence rate. Total phacoemulsification time and effective phacoemulsification time were significantly longer in the mature cataract patients (p = 0.038 and p = 0.041, respectively). BCVA, the amount of corneal endothelial cell density reduction and CMT at postoperative 1 year was not different between the two groups.

Conclusions

The success of complete CCC was a significant factor for the occurrence of intraoperative complications in mature cataract surgery. Based on the clinical results, the mature cataract patients and controls had a similar visual prognosis.

References

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Figure 1.
Postoperative changes in best corrected visual acuity (BCVA) (log MAR). Although the difference in BCVA between mature cataract and control patients was significant on postoperative day 1 and week 1 (p = 0.031 and p = 0.04, respectively), the difference was not significant at the 1-year fol-low-up (p > 0.05). MC = mature cataract.
jkos-57-891f1.tif
Table 1.
Baseline demographic features of enrolled patients
  Mature cataract Control p-value
Number (eyes) 37 37  
Age (year ± SD) 74.8 ± 9.63 70.1 ± 11.76 0.79*
Gender (male/female) 16/21 20/17  
Preop BCVA (log MAR) 0.910 ± 0.132 0.733 ± 0.085 0.31*
DM (%) 35.1 40.5 0.82
Dysthyroidism (%) 2.78 0

Values are presented as mean ± SD unless otherwise indicated.

SD = standard deviation; Preop = preoperative; BCVA = best corrected visual acuity; DM = diabetes mellitus.

* Analyzed with independent t-test

Analyzed with chi-square test.

Table 2.
Comparison of intraoperative and postoperative complications between the mature cataract and control patients
  Mature cataract (%) Control (%) p-value*
Incomplete CCC 10 (27.0) 1 (2.7) 0.025
Posterior capsule rupture 4 (10.8) 1 (2.7) 0.68
Decentration of IOL optic 4 (10.8) 1 (2.7) 0.68

CCC = continuous circular capsulorhexis; IOL = intraocular lens.

* Analyzed with chi-square test.

Table 3.
Comparison of mean surgical parameters between the mature cataract and control patients
  Mature cataract Control p-value*
Mean phaco time (sec) 19.35 ± 9.26 13.53 ± 10.17 0.21
Total phaco (%) 7.53 ± 3.21 4.94 ± 3.08 0.038
EPT (sec) 4.19 ± 3.17 1.19 ± 1.16 0.041
Total BSS used (mL) 59.0 ± 10.02 51.8 ± 6.1 0.098
Time of surgery (min) 25.44 ± 8.99 20.66 ± 6.37 0.39

Values are presented as mean ± SD unless otherwise indicated.

EPT = effective phaco time; BSS = balanced salt solution.

* Analyzed with independent t-test.

Table 4.
Postoperative changes in BCVA (log MAR), reduction of corneal endothelium and central foveal thickness
  Mature cataract Control p-value*
Postop. BCVA
 1 day 0.215 ± 0.061 0.108 ± 0.034 0.031
 1 week 0.155 ± 0.021 0.086 ± 0.029 0.04
 1 month 0.102 ± 0.019 0.081 ± 0.011 0.37
 3 months 0.077 ± 0.027 0.071 ± 0.013 0.56
 6 months 0.076 ± 0.018 0.066 ± 0.008 0.85
 1 year 0.080 ± 0.010 0.075 ± 0.012 0.76
Postop. reduction of corneal endothelium (cells/mm2)
 1 month 188 ± 89 150 ± 88 0.33
 1 year 190 ± 62 158 ± 42 0.35
Central foveal thickness (μm)
 Postop. 1 year 201 ± 56 187 ± 71 0.63

Values are presented as mean ± SD unless otherwise indicated.

BCVA = best corrected visual acuity; Postop. = postoperative time.

* Analyzed with independent t-test.

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