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In this cross-sectional review of the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) including 2,853,376 patients and 31,749 cases with posterior capsular rupture (PCR), the authors observed a trend of reduction in PCR rate from 1.44% in 2008 to 0.60% in 2018 (range: 1.65% to 0.60%). Risk factors identified included age, hyperopic target refraction, corneal opacities, diabetic retinopathy, the use of trypan blue, mechanical dilation of the pupil, and glaucoma. Age as a risk factor had an adjusted odds ratio (OR) of 1.007 and although the OR increased 0.007 for each additional year of age, this means an 80-year-old has a 20% higher chance of PCR compared with a 55-year-old patient. Higher PCR incidence in males could be secondary to a higher incidence of intraoperative floppy-iris syndrome (IFIS). Corneal opacities and diabetic retinopathy were associated with the highest ORs of 3.21and 2.74 respectively. A previous vitrectomy did not entail a higher risk of PCR in this analysis. Limitations of the study include the lack of data on previous intravitreal therapy and medication-induced IFIS, and that data are self-reported with an inherent risk of under-reporting.

Risk factors for posterior capsule rupture in cataract surgery as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery.
Segers MHM, Behndig A, van den Biggelaar FJHM, et al.
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Mahmoud Ahmed

Royal Liverpool University Hospital, UK.

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