Outcomes of “Complex” Cataract Surgeries Performed by Long-Term Glaucoma Fellows in a Tertiary Eye Centre from Eastern India

Abstract

Purpose

To evaluate the outcomes of operating on “complex cataracts” by the glaucoma fellows.

Patients and Methods

This was a retrospective study done at a tertiary referral eye care centre in eastern India. After obtaining IRB approval, a retrospective chart review of all patients who underwent “complex” cataract surgery by one of four long-term (2 years) glaucoma fellows between January 2016 and November 2020 was conducted. ‘Complex’ was defined as cataracts complicated with pseudoexfoliation syndrome, phacodonesis with or without blunt ocular trauma, posterior polar cataract, small pupil, co-existent corneal opacity or uveal coloboma, post-glaucoma filtering surgery, post-vitreoretinal surgery, co-existent glaucoma or post-laser iridotomy and monocular patients.

Results

Out of a total of 677 eyes done by the glaucoma fellows during the study period, 83 eyes had complex cataract surgery and completed the six-week post-operative follow-up. Intraoperative surgical complications like posterior capsular rent or vitreous loss were noted in 36 of the cases. Thirty of the eyes were left aphakic. Despite a high rate of complications, the LogMAR best-corrected visual acuity (mean ± standard deviation) improved from the preoperative level of 1.7 (±0.5) to 1.0 (± 0.8) at post-operative six weeks, significant at p < 0.001. As far as the surgeon’s experience was concerned—less than or more than a year since joining the fellowship—there was statistically no difference in the final visual acuity. The group with greater experience had shorter surgical time and lesser complications though this difference was not statistically significant.

Conclusion

This is the first study in the literature reporting the outcomes of “complex” cataract surgery performed by glaucoma fellows. Though high rates of postoperative complications were noted in this study, the mean best-corrected visual acuity improved significantly in all eyes after the surgery.

Keywords:

• complex cataract surgery
• complicated cataract surgery
• glaucoma fellows

Ethical Statement

Approved by the Institutional Review Board: Ethics committee of L.V Prasad Eye Institute, MTC campus, Bhubaneswar. Informed consent was waived by the ethics committee since it was a retrospective study and patients’ consent to review their records was not needed by the IRB.

Disclosure

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

Hyderabad Eye Research Foundation.