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A Case-Control Study

Jorge L. Arango, MD; Curtis E. Margo, MD, MPH

Arch Ophthalmol. 1998;116:1021-1024.

Objective  To determine whether selected preoperative medical, social, or behavioral factors predict the occurrence of cataract wound complications.

Patients and Methods  Patients who underwent cataract surgery at a Veterans Administration hospital were used in a case-control study. Cases were defined by the occurrence of any postoperative cataract wound gape with or without iris prolapse within 12 weeks of surgery and requiring repair in the operating room. Controls were patients who had no postoperative complications. Two controls were selected for each case patient and matched for surgeon.

Results  Thirty-one patients with postoperative wound complications occurred after 2041 cataract extractions (1.5%). Occurrence of wound complications was predicted by previous hematologic disorder (odds ratio, 2.9; 95% confidence interval, 1.1-8.1). Phacoemulsification surgery had a protective effect against wound complication (odds ratio, 0.2; 95% confidence interval, 0.09-0.64). There was no difference in final visual acuity and refractive indexes in patients with and without wound complications (P=.6 by Student t test).

Conclusions  Most medical, social, and behavioral preoperative factors have limited discriminatory power in predicting who will have postoperative cataract wound complications. The association of previous hematologic disorders to predict the occurrence of wound complications varied with the level of alcohol use. Although this study was not primarily designed to assess the role of surgical technique, phacoemulsification cataract extraction had a statistically significant protective effect against wound complications. Visual outcome in patients with postoperative wound complications is generally very good.

From the Section of Ophthalmology, James A. Haley Veterans Hospital, Tampa, Fla, and the Department of Ophthalmology, University of South Florida, College of Medicine, Tampa.