National outcomes of cataract extraction. III. Corneal edema and transplant following inpatient surgery
J. K. Canner, J. C. Javitt and A. M. McBean
Worthen Center for Eye Care Research, Georgetown University Medical Center, Washington, DC 20007.
We analyzed the likelihood of rehospitalization for corneal edema or
corneal transplantation in all 338,141 Medicare beneficiaries older than 65
years who were admitted to US hospitals for cataract extraction in 1984.
The rate of rehospitalization for corneal edema or transplant within 4
years of intracapsular cataract extraction was 1.4%, almost twice the rate
associated with extracapsular extraction (0.63%) or phacoemulsification
(0.62%; P less than .0001). No significant difference in the rate of
corneal transplantation was detected between those undergoing extracapsular
cataract extraction and those undergoing phacoemulsification. Among
patients who had intracapsular cataract extraction, those who underwent
concurrent intraocular lens implantation surgery had a higher rate of
rehospitalization for corneal edema or transplantation than those who did
not (1.11% vs 0.86%; P = .0003). However, this difference is only manifest
starting at about 3 years after surgery. Among patients who underwent
extracapsular cataract extraction and phacoemulsification, however, those
who underwent intraocular lens implantation during surgery had a lower rate
of corneal edema or transplantation than those who did not (0.47% vs 0.74%;
P less than .0001). This difference was seen almost immediately after
surgery. Cataract surgery accompanied by anterior vitrectomy was associated
with a threefold increase in the 4-year rate of corneal edema or
transplantation compared with cataract surgery alone (2.42% vs 0.87%; P
less than .0001).
