To evaluate the visual outcomes after vitreous loss during cataract surgery performed by residents.
Parkland Memorial Hospital, Dallas, Texas, USA.
A retrospective chart review of all patients who had cataract extraction complicated by vitreous loss from 1997 through 1999 was conducted. All surgery was performed by third-year ophthalmology residents.
In 1400 cataract surgeries, 63 cases of vitreous loss (rate 4.5%) were identified. One case had less than 1 month of follow-up and was excluded from further analysis. Of the 62 remaining cases, 53 had phacoemulsification, 7 extracapsular cataract extraction (ECCE), 1 phacoemulsification converted to ECCE, and 1 intracapsular cataract extraction. Thirty-two eyes had a sulcus-fixated posterior chamber intraocular lens (PC IOL) implanted, 20 an anterior chamber IOL, and 7 a PC IOL in the capsular bag; 3 eyes were left aphakic at the time of initial surgery. Overall, 77% of patients had a postoperative best corrected visual acuity (BCVA) of 20/40 or better. Of the 14 patients who did not have a BCVA of 20/40 or better, 9 had preexisting ocular pathology affecting vision. If these 9 patients are excluded, 91% of patients with vitreous loss had a BCVA of 20/40 or better. Six patients (10%) developed clinical cystoid macular edema. No patient with vitreous loss developed a retinal detachment or endophthalmitis.
Good visual acuity can be achieved after resident cataract surgery complicated by vitreous loss. The rate of vitreous loss in this study is consistent with that in previous reports of resident cataract surgery in the literature.