Purpose To analyze the surgical risks and outcomes of phacoemulsification in patients aged 90 years and older.
Method A retrospective case series of 132 patients aged 90 years or more (148 eyes) underwent cataract phacoemulsification between Jan 2010 and Dec 2011 was included. Age, sex, lens and ocular parameters, surgical reports, preoperative and postoperative visual acuity (VA), and postoperative complications were recorded and analyzed.
Results Average age of these patients was 91.45±2.11 years(range from 90ys to 100ys). The sex ratio male to female was 47:75. According to the Emery criteria, grade II 3 eyes, grade III 23 eyes, grade IV 73 eyes, grade V 49 eyes; 71 white cataracts were included. Posterior capsular tear (4.73% compare to the average rate 1.76% of the corresponding period of the same surgical centre) was the most prevalent operative complication. Overall VA improvement was 83.8%, about 28.4% of patients achieved uncorrected VA of 20/40 or better at day 7, compared to 1.35% preoperatively. The main reasons for unimproved VA were AMD, glaucomatous neuropathy, diabetic retinopathy.
Conclusion Very elderly patients are prone to have denser and thicker cataracts, looser ligaments and smaller pupils that increase the risk for surgical complications. But most of them can achieve VA improvement. Adequate recognition and preparation to deal with general and ocular comorbidities of these patients is the key to successful surgeries. |
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