An observational study to compare Muhtaseb's and Habib's scoring systems in patients undergoing phacoemulsification to predict risk in cataract at a tertiary centre in West Bengal

Jagan Nandan Prasad Singh; Atanu Biswas

doi:10.18203/2320-6012.ijrms20231418

Authors

Jagan Nandan Prasad Singh Department of Ophthalmology and JNM Hospital, Kalyani, West Bengal, India
Atanu Biswas Department of Ophthalmology and JNM Hospital, Kalyani, West Bengal, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20231418

Keywords:

Snellen’s chart, Posterior capsular rupture, Posterior polar cataract

Abstract

Background: Cataract is derived from the Latin ‘cataracta’, meaning ‘waterfall’ as rapidly running water turns white, so term may have been used metaphorically to describe similar appearance of mature ocular opacities.¹

Methods: This observational study with prospective study design has been conducted in the college of medicine and JNM hospital, department of ophthalmology, COMJNMH, Kalyani-741235, Nadia District, West Bengal which catering mostly the rural and also urban population. The study was done spread over a period of 18 months starting from July 2018 to December 2019, i.e., 1 year for research and 6 months for analysis. It included all patients, irrespective of age, undergoing Phacoemulsification surgery for cataract admitted in our hospital fulfilling the laid criteria for the study.

Results: The study consisted of total 147 cases in these 14 (9.52%) cases complicated with PCR, 10 (6.80%) striate keratopathy and 4 (2.72%) cases complicated with both PCR and striate keratopathy. Though sample size derived was 126 cases, 147 cases were studied during the research period of 1 year. Out of 10.89% cases of miscellaneous risk (ex: poor position of the eye/patient) risk factor, posterior capsule rupture (12.5%), striate keratopathy (12.5%), cases having both complication (00.0%) and total complicated cases (25%) which is 1.36%, 1.36%, 0% and 2.72% of total cases respectively. Out of 8.84% cases of unable to lie flat risk factor, posterior capsule rupture (15.38%), striate keratopathy (7.69%), and total complicated cases (23.07%) which is 1.36%, 0.68% and 2.04% of total cases respectively.

Conclusions: The current study tries to validate two scoring systems to predict complications during phacoemulsification surgerylike risk of posterior capsule rupture and striate keratopathy and to predict the potential difficulty of a case.

Metrics

Metrics Loading ...

References

WHO Team. The Global Burden of Disease: 2004 Update. Geneva, Switzerland: World Health Organization. 2008;35-42. Available at: https://apps.who.int/iris/handle/10665/43942. Accessed on 3 November 2022.

Goes, Joseph F. The Eye in The History. JP Medical Ltd. 2013;367-71.

Bonnie H. Extracapsular Cataract Extraction. Essentials of Cataract Surg. 2007;187-92.

Leanming DY. Practice Styles and Preferences of ASCRS Members-1996 Survey. J Cataract Refract Surg. 1997;23:527-35.

Enubi K, Sam YY, Young JS. Studies On Cornea and Lens, Springer. 2014;4-10.

Pascal H. Essential Principles of Phacoemulsification. JP Medical Ltd. 2013;21-32.

Gault J, Vander J. Ophthalmology Secrets in Colour. Elsevier Health Sciences. 2015;221-31.

Ng DT. Intraoperative Complications of 1000 Phacoemulcification Procedure: A Prospective Study. J Cataract Refract Surg. 1998;24:1390-95.

Ang GS, Whyte IF. Effect and Outcome of Posterior Capsule Rupture in District General Hospital Setting. J Cataract Refract Surg. 2006;32:623-7.

Smith JH, Seiff Sr. Outcome of Cataract Surgery by Resident ata Public Country Hospital. Am J Ophthalmol. 1997;123:448-54.

Muhtaseb M, Kalhoro A, Lonides A. A System for Preoperative Stratification of Cataract Patient According to Risk of Intra Operative Complication: A Prospective Analysis of 1441 Cases. Br J Ophthalmol. 2004;88:1242-6.

Habib MS, Bunce CY, Fraser SG. The Role of Case Mix in The Relation of Volume and Outcome in Phacoemulsification. Br J Ophthalmol. 2005;89(9):1143-6.

Blomquist PH, Sargent JW, Winslow HH. Validation of Najjar-Awad Cataract Surgery Risk Score for Resident Phacoemulsification Surgery. J Cataract Refractive Surg. 2010;10:1753-7.

Tarbet KJ, Mamalis N, Theurer J, Jones BD, Oslon RJ. Complications and results of phacoemulsification performed by residents. J Cataract Refract Surg. 1995;21:661-5.

Corey RP, Olson RJ. Surgical Outcomes of Cataract Extractions Performed by Residents Using Phacoemulsification. J Cataract Refract Surg. 1998;24:66-72.

Lee JS, Hou CH, Yang ML, Kuo JZC, Lin KK. A different approach to assess resident phacoemulsification learning curve: Analysis of both completion and complication rates. Eye. 2009;23:683-7.

Rutar T, Porco TC, Naseri A. Risk Factors for Intraoperative Complications in Resident-Performed Phacoemulsification Surgery. Ophthalmology. 2009;116:431-6.

Chakbarti A. Posterior Capsular Rent Prevention and Management. Indian J Ophthalmol. 2017;65(12):1359-69.

Narendran N, Jaycock P, Johnston RL, Taylor H, Adams M, Tole DM et al. The Cataract National Dataset Electronic Multicentre Audit of 55,567 Operations: Risk Stratification for Posterior Capsule Rupture and Vitreous Loss. Eye (Lond). 2009;23:31-7.

Chen M, Lamattina KC, Patarianakos T, Dwarakanathan S. Complication rate of posterior capsule rupture with vitreous loss during phacoemulsification at a Hawaiian cataract surgical centre: A clinical audit. Clin Ophthalmol. 2014;8:375-8.

Hashemi H, Mohsmmadpour M, Jabbarvand M, Nezamdoost Z, Ghadimi H. Incidence of and risk factors for vitreous loss in resident-performed phacoemulsification surgery. J Cataract Refract Surg. 2013;39:1377-82.

Dada T, Sharma N, Vajpayee RB, Dada VK. Conversion from phacoemulsification to extracapsular cataract extraction: Incidence, risk factor, and visual outcome. J Cataract Refract Surg. 1998;24:1521-4.

Fernandez-Buenaga R, Alio JL, Perez-Ardoy AL. Late in-the-bag intraocular lens dislocation requiring explanation: Risk factors and outcomes. Eye (Lond). 2013;27(7):795-801.

Zuberbuhler B, Seyedian M, Tuft S. Phacoemulsification in eyes with extreme axial myopia. J Cataract Refract Surg. 2009;35(2):335-40.

Fesharaki H, Peyman A, Rowshandel M, Peyman M, Alizadeh P, Akhlaghi M et al. A comparative study of complications of cataract surgery with phacoemulsification in eyes with high and normal axial length. Adv Biomed Res. 2012;1:67-73.

Haigis W. Intraocular lens calculation after refractive surgery for myopia: Haigis L formula. J Cataract Refract Surg. 2008;34(10):1658-63.

Naumann G. Exfoliation syndrome as a risk factor for vitreous loss in extracapsular cataract surgery. Acta Ophthalmol. 1988;184:S129-31.

Kuchle M, Schonherr U, Dieckmann U. Risk factors for capsular rupture and vitreous loss in extracapsular cataract extraction. Fortschr Ophthalmol. 1989;86:417-21.

Waldmann NP. Cataract Surgery in High Hyperopia Klin Monatsbl Augenheillkd. 2018;235(04):413-5.

Berler DK. Intraoperative complications during cataract surgery in the very old. Trans Am Ophthalmol Soc. 2000;98:127-30.

Chakbrati A, Singh S, Krishnadas R. Phacoemulsification in eyes with white cataract. J Cataract Refract Surg. 2000;26:1041-7.

Singh R, Vasavada A, Janaswamy G. Phacoemulsification of brunescent and black cataracts. J Cataract Refract Surg. 2001;27:1762-9.

Vasavada A, Singh R. Phacoemulsification in eyes with posterior polar cataract. J Cataract Refract Surg. 1999;25:238-45.

Osher R, Yu BCY, Koch D. Posterior polar cataracts: A predisposition to intraoperative capsular rupture. J Cataract Refract Surg. 1990;16:157-62.

Osborne SA, Adams WE, Bunce V, Fraser SG. Validation of Two Scoring Systems for the Prediction of Posterior Capsule Rupture During Phacoemulsification Surgery. Br J Ophthalmol. 2006;90:333-6.

George D Kymionis et al. Anterior Segment Optical Tomography for Demonstrating Posterior Capsular Rent in Posterior Polar Cataract. J Clin Ophtalmol. 2014;8:215-7.

Zare M. In study of Risk Factors for Posterioe Capsule Rupture and Vitreous Loss during Phacoemulsification. J Ophthalmic Vis Res. 2009;4(4):208-12.

Lumme P, Laatikainen LT. Risk factors for intraoperative and early postoperative complications in extracapsular cataract surgery. Eur J Ophthalmol. 1994;4:151-8.

Awan KJ, Humayun M. Extracapsular cataract surgery risks in patients with exfoliative syndrome. Pakistan J Ophthalmol. 1986;2:79-80.

Landa G. Manual removal of primary posterior capsular plaques using retinal end grasping forceps. Ophthalmol Ther. 2017;6(2):351-3.

Osborne SA, Severn P, Bunce CV, Fraser SG. The Use ofa Pre-Operative Scoring System for The Prediction of Phacoemulsification Case Difficulty and The Selection of Appropriate Cases to Be Performed by Trainees. BMC Ophthalmol. 2006;6:38.

Hayashi K, Hayashi H, Nakao F. Outcomes of surgery for posterior polar cataract. J Cataract Refract Surg. 2003;29:45-9.

Mullhern M, Kelly G, Barry P. Effects of posterior capsular disruption on the outcome of phacoemulsification surgery. Br J Ophthalmol. 1995;79:1133-7.

Tyson S. A system for preoperative stratification of cataract patients according to risk of complications: A prospective analysis of 1441 cases comment. Evidence Based Eye Care. 2005;6:121-3.