Incidence and risk factors for vitreous loss in residents performing manual small-incision cataract surgery
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Rajesh Subhash Joshi. Department of Ophthalmology, Government Medical College, Nagpur-440003, Maharashtra, India. jrajesh5@rediffmail.com

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    Abstract:

    AIM: To assess the incidence of vitreous loss and associated risk factors in residents performing manual small-incision cataract surgery (MSICS). METHODS: The present retrospective record review study was performed on 490 patients who underwent MSICS performed between November 2018 and December 2019 by 7 third-year postgraduate residents. The study group comprised of patients having intraoperative vitreous prolapse. All the surgeries were performed under supervision of a trained assistant. RESULTS: The mean age of the participants at the time of surgery was 68.42±2.05y. Of the 490 patients, 250 patients were male, and 240 patients were female (P=0.23). A total of 215 (43.9%) eyes had mature white cataract, 185 (37.8%) eyes had brown cataract, and 90 (18.3%) eyes had immature senile cataract. The incidence of intraoperative vitreous loss among residents was 2% (10/490). Vitreous loss occurred during hydrodissection [1/10 (10%)], nucleus delivery [3/10 (30%)], irrigation and aspiration [5/10 (50%)], and intraocular lens insertion [1/10 (10%)]. Multivariate stepwise Logistic regression analysis confirmed immature senile cataract [odds ratio (OR)=3.99; P=0.02], irrigation and aspiration of cortical material (OR=3.07; P=0.03), and anterior capsular extension (OR=3.22, P=0.03) as independent risk factors for vitreous loss. CONCLUSION: Immature senile cataract, irrigation and aspiration of cortical material, and anterior capsular extension are independent risk factors for vitreous loss. Our findings may serve as a guide for future trainers or residents learning MSICS.

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Rajesh Subhash Joshi, Ashok Hukumchand Madan, Preeti Dashrath Wadekar, et al. Incidence and risk factors for vitreous loss in residents performing manual small-incision cataract surgery. Int J Ophthalmol, 2022,15(7):1071-1076

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Publication History
  • Received:June 28,2021
  • Revised:February 21,2022
  • Adopted:
  • Online: June 30,2022
  • Published: