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Kim, Kim, and Kim: The Safeness of Cataract Surgery in Older Subjects
Original Article

J Korean Ophthalmol Soc 2016;57(7):1044-1049.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.7.1044

The Safeness of Cataract Surgery in Older Subjects

Min Ho Kim, MD, Man Soo Kim, MD, PhD, Eun Chul Kim, MD, PhD

Department of Ophthalmology and Visual Science, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea

Address reprint requests to Eun Chul Kim, MD, PhD Department of Ophthalmology, The Catholic University of Korea Bucheon St. Mary's Hospital, #327 Sosa-ro, Wonmi-gu, Bucheon 14647, Korea Tel: 82-32-340-2125, Fax: 82-32-340-2126 E-mail: eunchol@hanmail.net

Received 7 April 2016       Accepted 9 June 2016

Copyright © 2016 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the safeness of cataract surgery in older subjects by comparing the outcomes among different age groups.

Methods

The present study included 150 patients (150 eyes) diagnosed with cataracts that visited the hospital from January 2014 to May 2015 and received phacoemulsification and intraocular lens implantation. The subjects were divided into 5 age groups (40–50, 50–60, 60–70, 70–80 and 80–90). Among the study subjects, 30 patients from each age group were measured for best corrected visual acuity (BCVA), and endothelial cell density (ECD) 2 months after surgery. Intraoperative ultrasound time, cumulative dissipated energy (CDE) and volume of balanced salt solution were also compared among the subjects.

Results

The nuclear sclerosis of cataracts before surgery was significantly lower in the 40–50 (2.85 ± 1.05), 50–60 (3.20 ± 0.81), and 60–70 age groups (3.39 ± 0.67) than the 70–80 (4.23 ± 0.68) and 80–90 age groups (4.47 ± 0.51). The CDE during surgery was significantly lower in the 40–50 (10.10 ± 3.20), 50–60 (11.20 ± 3.20) and 60–70 age groups (12.40 ± 3.50) than in the 70–80 (15.10 ± 3.80) and 80–90 age groups (16.70 ± 3.90; p < 0.05). BCVA was not significantly different among the age groups 2 months after surgery (p > 0.05). The reduction (%) of ECD 2 months after surgery was significantly lower in the 40–50 (17.94 ± 13.50), 50–60 (17.46 ± 9.08) and 60–70 age groups (19.12 ± 16.01) than in the 70–80 (26.36 ± 10.82) and 80–90 age groups (31.80 ± 16.86; p < 0.05).

Conclusions

After cataract surgery, BCVA was not significantly different among the age groups. These findings indicate that cataract surgery using phacoemulsification in older patients is recommended and a viable option since it is relatively safe and provides excellent BCVA effects.

Keywords: Cataract surgery, Older people, Safeness

References

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Figure 1.
Corneal endothelial cell loss. * p-values were calculated using one-way analysis of variance (ANOVA). The one-way ANOVA was used to check if there is the difference of corneal endothelial cell loss among the five groups; Group A (n = 30): 40–49 years, Group B (n = 30): 50–59 years, Group C (n = 30): 60–69 years, Group D (n = 30): 70–79 years, Group E (n = 30): 80–89 years.
jkos-57-1044f1.tif
Table 1.
Preoperative clinical characteristics of each group
  Group A Group B Group C Group D Group E
Age (years) 45.90 ± 2.46 55.40 ± 2.37 64.30 ± 3.30 74.10 ± 2.54 82.30 ± 2.23
UCVA (log MAR) 0.49 ± 0.21 0.46 ± 0.19 0.36 ± 0.15 0.52 ± 0.19 0.59 ± 0.25
BCVA (log MAR) 0.29 ± 0.15 0.35 ± 0.20 0.34 ± 0.23 0.37 ± 0.15 0.39 ± 0.16
ECD (cells/mm²) 2,875.00 ± 289.61* 2,528.00 ± 352.36 2,664.40 ± 391.86 2,686.60 ± 525.27 2,630.00 ± 425.34
NO Grade 2.85 ± 1.05* 3.20 ± 0.81* 3.39 ± 0.67* 4.23 ± 0.68 4.47 ± 0.51

Values are presented as mean ± SD.

UCVA = uncorrected visual acuity; BCVA = best corrected visual acuity; ECD = endothelial cell density, NO = nuclear opalescence (Grade 1–6).

* p-values were calculated using one-way analysis of variance (ANOVA). The one-way ANOVA was used to check if there is the difference of each parameters among the five groups; Group A (n = 30): 40–49 years, Group B (n = 30): 50–59 years, Group C (n = 30): 60–69 years, Group D (n = 30): 70–79 years, Group E (n = 30): 80–89 years.

Table 2.
Preoperative and intraoperative problems of cataract surgery
  Group A Group B Group C Group D Group E
Zonulysis 1 1 1 0 3
Small pupil 0 0 1 1 2
Hypermature Cataract 0 0 0 0 2
Floppy iris syndrome 0 0 0 1 0
CCC Extension 1 0 0 0 0
PC rupture 0 1 0 0 1
Total 2 2 2 2 8

Group A (n = 30): 40–49 years, Group B (n = 30): 50–59 years, Group C (n = 30): 60–69 years, Group D (n = 30): 70–79 years, Group E (n = 30): 80–89 years.

CCC = continuous curvilinear capsulorhexis; PC rupture = posterior capsule rupture.

Table 3.
Intraoperative parameter
  Group A Group B Group C Group D Group E
UST (seconds) 10.70 ± 11.65* 31.90 ± 11.69 29.10 ± 9.21 32.60 ± 11.00 33.70 ± 12.85
CDE (%) (seconds) 10.10 ± 3.20* 11.20 ± 3.20* 12.40 ± 3.50* 15.10 ± 3.80 16.70 ± 3.90
Used BSS volume (mL) 34.20 ± 20.34* 47.90 ± 36.10* 49.50 ± 27.14* 87.70 ± 54.47 104.40 ± 65.32

Values are presented as mean ± SD.

UST = ultrasound time; CDE = cumulative dissipated energy; BSS = balanced salt solution.

* p-values were calculated using one-way analysis of variance (ANOVA). The one-way ANOVA was used to check if there is the difference of each parameters among the five groups; Group A (n = 30): 40–49 years, Group B (n = 30): 50–59 years, Group C (n = 30): 60–69 years, Group D (n = 30): 70–79 years, Group E (n = 30): 80–89 years.

Table 4.
Postperative clinical characteristics of each group (postoperative day #2 months)
  Group A Group B Group C Group D Group E
UCVA (log MAR) 0.06 ± 0.01* 0.09 ± 0.01 0.12 ± 0.02 0.15 ± 0.02 0.15 ± 0.03
BCVA (log MAR) 0.03 ± 0.01 0.04 ± 0.01 0.04 ± 0.01 0.04 ± 0.01 0.04 ± 0.01
ECD loss (%) 17.94 ± 13.50* 17.46 ± 9.08* 19.12 ± 16.01* 26.36 ± 10.82 31.80 ± 16.86

Values are presented as mean ± SD.

UCVA = uncorrected visual acuity; BCVA = best corrected visual acuity; ECD = endothelial cell density.

* p-values were calculated using one-way analysis of variance (ANOVA). The one-way ANOVA was used to check if there is the difference of each parameters among the five groups; Group A (n = 30): 40–49 years, Group B (n = 30): 50–59 years, Group C (n = 30): 60–69 years, Group D (n = 30): 70–79 years, Group E (n = 30): 80–89 years.

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