Phacoemulsification at King Khaled eye specialist hospital the experience of the past

Objective: To study the outcome ofphacoemulsification (PE) compared to standardextracapsular surgery before the introduction ofstate-of-the-art techniques (capsulorhexis,hydrodissection, nuclear cracking, nuclear chopping,sutureless incisions) and sophisticated equipment. Study design: Charts from 375 patients (453 eyes)undergoing PE between 1984 and 1989 were randomlyselected and studied retrospectively. A minimum ageof 35 years, and a minimum follow-up of three monthswere required.Setting: A large eye hospital in the Kingdom of SaudiArabia staffed with an international faculty ofophthalmic surgeons.Patients: Patients over 35 years of age undergoing PE for immature, mature and traumatic cataract.Main outcome measures: Postoperative visual acuity,and rate or frequency of intraoperativecomplications. Results:66.5% achieved visual acuity of 20/40 orbetter, which compares favourably with the 36.5% ofeyes reaching this level of visual acuity after mainlystandard extracapsular cataract surgery in anotherstudy at our hospital. Posterior capsule rupturesoccurred in 7.5% and vitreous loss in 5.5%. Otherocular disease (odds ratio 7.51 confidence interval4.43-12.7) and intraoperative complications (oddsratio 2.97 confidence interval 1.38-6.42) werestatistically significant predictors for final visualacuity of under 20/40 (p = <0.001 and 0.005respectively). Conclusion: The outcome of PE was better than that ofstandard extracapsular cataract extraction in the samesetting. However, since PE appeared to be usedselectively, no clear advantage compared toextracapsular cataract extraction is evident in theperiod before the introduction of modern state-of-the-art PE-techniques.