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Risk factors affecting visual outcomes following dropped nucleus after cataract surgery

Eye volume 38, pages 253–258 (2024)Cite this article

Subjects

Abstract

Background/ Aims

To describe the visual outcomes in eyes with dropped nucleus during phacoemulsification surgery.

Setting

Singapore National Eye Centre (SNEC).

Design

Retrospective chart review of prospectively reported cases of dropped nucleus.

Methods

The clinical charts of all cases of dropped nucleus (Jan 2001 to Dec 2016) were retrospectively reviewed for patient demographics, surgeon type, stage of surgery, timing of pars plana vitrectomy (PPV), and complications. Visual success was defined as best corrected visual acuity (BCVA) ≥ 20/40 at last review. Final risk factors affecting visual success were identified using multivariate logistic regression analysis.

Results

Incidence of dropped nucleus following cataract surgery was 0.17% (n = 292). Duration of follow-up was 25.5 months (mean), 18.5 months (median). There was a statistically significant difference in dropped nucleus rate between Residents (0.3%) and Faculty (0.14%) (x2 = 38.2, P < 0.001), but ensuing major complications rates were similar. PPV was performed in 251 eyes (87.2%). At final examination, 202 cases (85.2%) achieved BCVA 20/40 or better, after excluding patients with co-existing ocular pathology. Timing of vitrectomy (delayed vs same-day) did not influence the final visual success (x2 = 0.969, p = 0.51). Risk factors for poor visual outcomes included age >70 years, absence of intraocular lens (IOL) implant, and presence of major complications.

Conclusion

Overall incidence of dropped nucleus in SNEC was 0.17%, with BCVA of 20/40 or better in 85.2% cases. Visual prognosis was influenced by patient’s age, presence of IOL implant or additional major complications.

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Data availability

The data used in this study cannot be shared publicly due to privacy concerns in accordance with the Personal Data Protection Act (PDPA) of Singapore. The PDPA safeguards the personal information of individuals and imposes restrictions on the collection, use, and disclosure of such data. The data utilised in this research contain sensitive and personally identifiable information that, if disclosed, could potentially breach the privacy rights of individuals. This includes but is not limited to personal identifiers, contact details, and other confidential information. The research team is committed to upholding the principles of data protection and privacy as outlined by the PDPA. As a result, the data will only be accessible to authorised individuals involved in the study who are bound by strict confidentiality agreements. These individuals will utilise the data solely for the purposes of this study and will not disclose or share it with any unauthorised third parties. While the research findings and conclusions drawn from the data will be disseminated in academic or scientific publications, any information shared will be anonymized or aggregated to ensure that individuals’ privacy is protected. This ensures that no personally identifiable information can be derived from the published results. The restrictions on data availability are implemented to maintain compliance with the PDPA and to ensure the privacy and confidentiality of the individuals involved. The researchers acknowledge the importance of protecting personal data and are dedicated to abiding by the legal and ethical obligations set forth by the PDPA. For any inquiries regarding the data or requests for further information related to the research study, please contact Dr Jeremy Hu at hujeremy@hotmail.com.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, 10 Kent Ridge Crescent Singapore, 119260, Singapore, Singapore

    Jeremy Youwei Hu, Seng-Ei Ti & Soon-Phaik Chee

  2. Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore

    Jeremy Youwei Hu

  3. Lee Kong Chian School of Medicine, 11 Mandalay Rd, Singapore, 308232, Singapore

    Jeremy Youwei Hu

  4. Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore, 168751, Singapore

    Seng-Ei Ti & Soon-Phaik Chee

  5. Singapore Eye Research Institute, 11 Third Hospital Avenue, Singapore, 168751, Singapore

    Seng-Ei Ti & Soon-Phaik Chee

  6. Duke-National University of Singapore Graduate Medical School, 8 College Road, Singapore, 169857, Singapore

    Seng-Ei Ti & Soon-Phaik Chee

Authors
  1. Jeremy Youwei Hu
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  2. Seng-Ei Ti
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  3. Soon-Phaik Chee
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Contributions

JH: Conceived and designed the study, collected and analysed data, and draughted and revised the manuscript. TSE: contributed to data analysis, and interpretation, and provided substantial manuscript revisions. CSP: Provided guidance in study design, contributed to data analysis and interpretation, and critically revised and approved the final manuscript.

Corresponding author

Correspondence to Soon-Phaik Chee.

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Hu, J.Y., Ti, SE. & Chee, SP. Risk factors affecting visual outcomes following dropped nucleus after cataract surgery. Eye 38, 253–258 (2024). https://doi.org/10.1038/s41433-023-02668-9

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