| Abstract: |
SUMMARYThe aim of this study is to record the complications of phacoemulsification during the learning curve.120 cases were selected of out patients presenting with cataract at the ophthalmic out patient clinic of Zagazig University hospitals with exclusion of patients with retinal detachment, corneal problems, traumatic cataract, with diabetes more than 5 years, with complicated cataract to high myopia, uveitis or glaucoma, also patients with only one seeing eyes were excluded.Preoperative assessment in the study included visual acuity testing, fundus ex. If possible, slit. Lamp ex. Ultrasnograply and biometry.In this study we noticed and recorded the complications and the difficulties of phacoemulsification during the learning curve in the first 60 cases and the second 60 cases in this study.The study included 95 males and 25 females, then age ranged from 40-70 years. 70 cases were right eye cataract while 50 cases were left.The most frequent type of the cataract in this study was posterior subcapsular cataract (Grad 3) 55 cases while the least frequent type was the snile nuclear cataract (grad 4) 30 cases.Preoperative absolute visual acuity ranged from hand movements to 6/60, in all examined eyes good projection was present.General anaesthesia was used in 36 cases while local retro bulbar anaesthesia with facial a kinesia was used in 84 cases.The phacoemulsification was planed for the studied cases with the same machine and with only one technique (Divide and Conquer), staining of anterior capsule for capsulorhexis using trypan blue was done in 30 cases in this study.As regards to operative difficulties, capsulorhexis, narrowing of the pupil, trauma of the iris, iris prolapse, the difference was statistically was highly significant between the results of the first 60 cases and that of second 60 cases while no statistical difference as regards to corneal burn, subincisional cortex aspiration, nucleus division, corneal haziness and movements of the globe.Fault in the machine was one of difficulties and one of causes conversion to ECCE with non significant statistical difference.As regards to interoperative complications, the incidence of PCR and vitreous loss was the same in both groups and conversion to ECCE is markedly declined in the second 60 cases, leading to significant statistical difference between both groups.Postoperative complications, like post operative iridocyclitis, rise of interaoculer pressure, post operative endophthalmitis, corneal oedema, subconjunctival hemorrhage, posterior capsule opcification, cystoid maculer oedema and irregular pupil, the difference between the first 60 cases and the second 60 cases was insignificant.BCVA in our study was 6/18 or worse was occurred in 96 cases (80%) while BCVA of 6/12 or better was recorded in 24 cases (20%).
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