Citation:Joshi RS,Madan AH,Wadekar PD,Patil N,Tamboli S,Surwade T,Bansode N.Incidence and risk factors for vitreous loss in residents performing manual small-incision cataract surgery.Int J Ophthalmol 2022;15(7):1071-1076,doi:10.18240/ijo.2022.07.05
Incidence and risk factors for vitreous loss in residents performing manual small-incision cataract surgery
Received:June 28, 2021  Revised:February 21, 2022
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DOI:10.18240/ijo.2022.07.05
Key Words:manual small-incision cataract surgery  complications of cataract surgery  vitreous loss
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Rajesh Subhash Joshi Department of Ophthalmology, Government Medical College, Nagpur-, Maharashtra, India
Ashok Hukumchand Madan Department of Ophthalmology, Government Medical College, Nagpur-, Maharashtra, India
Preeti Dashrath Wadekar Department of Ophthalmology, Government Medical College, Nagpur-, Maharashtra, India
Nivedita Patil Department of Ophthalmology, Government Medical College, Nagpur-, Maharashtra, India
Sonali Tamboli Department of Ophthalmology, Government Medical College, Nagpur-, Maharashtra, India
Tanmay Surwade Department of Ophthalmology, Government Medical College, Nagpur-, Maharashtra, India
Namrata Bansode Department of Ophthalmology, Government Medical College, Nagpur-, Maharashtra, India
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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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