Risk Factors for Posterior Capsular Tear and Vitreous Loss during Phacoemulsification in a Tertiary Eye Center

To report the rate of vitreous loss during phacoemulsification and its contributing risk factors in patients operated on at Labbafinejad Medical Center. This prospective comparative descriptive study included patients with cataract undergoing phacoemulsification by ophthalmology residents or cornea fellows from November 2006 to November 2007. All patients underwent a complete ocular examination including visual acuity, slitlamp examination, and dilated funduscopy, preoperatively. Phacoemulsification was performed under local or general anesthesia using Divide & Conquer technique. Main outcome measures included posterior capsular tear and vitreous loss and predisposing factors such as surgeon’s experience, ocular and systemic conditions, and type and severity of the cataract. Overall 767 patients including 393 male and 374 female subjects with mean age of 62.7±12.0 (range 6-96) years were studied. The overall rate of vitreous loss was 7.3% which was 5-fold higher in the hands of residents than fellows. Patients’ age and female sex, small capsulorrhexis, small pupil, pseudoexfoliation, and high myopia were other significant risk factors. The highest rate of vitreous loss occurred in patients with dense nuclear cataracts. Since ophthalmology residents had a higher rate of vitreous loss, patients with risk factors such as pseudoexfoliation, high myopia, and dense nuclear cataracts are better operated by more experienced surgeons.