Estimating the rate of severe visual loss (wipe-out) following cataract surgery, a British Ophthalmological Surveillance Unit (BOSU) study.
Journal
Eye (London, England)
ISSN: 1476-5454
Titre abrégé: Eye (Lond)
Pays: England
ID NLM: 8703986
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
21
04
2022
accepted:
25
05
2023
revised:
21
03
2023
pmc-release:
01
12
2024
medline:
7
12
2023
pubmed:
17
6
2023
entrez:
16
6
2023
Statut:
ppublish
Résumé
A sudden, irreversible reduction in visual acuity ('wipe-out') is a feared complication of cataract surgery. Current literature on wipe-out is limited in quantity and quality, and largely predates modern cataract surgery and imaging techniques. The objectives of our study were to estimate the incidence of wipe-out and to identify potential risk factors. We prospectively collated cases of wipe-out occurring in the UK during a 25-month study period using the British Ophthalmic Surveillance Unit reporting system. A total of 21 potential cases of wipe-out were reported, 5 of which met all inclusion and exclusion criteria. The estimated incidence of wipe-out during the study period was 0.00000298, or approximately 3 cases per million cataract operations. All cases of wipe-out occurred exclusively in patients with advanced glaucoma (mean deviation -21.0 decibels or worse in the operated eye), with an over-representation of black people (40%) in our case series. A prior diagnosis of retinal vein occlusion (60%) and elevated post-operative IOP (40%) were more common among individuals suffering from wipe-out compared to the general population, suggesting these factors may contribute to the pathogenesis of wipe-out. Our study shows that wipe-out is a rare complication, affecting approximately 3 per million undergoing cataract surgery. Patients with advanced glaucoma, black patients, and those with previous retinal vein occlusions may be at greater risk of wipe-out. We hope that the findings of our study will be used to help inform treatment decision-making and the cataract surgery consent process.
Sections du résumé
BACKGROUND
BACKGROUND
A sudden, irreversible reduction in visual acuity ('wipe-out') is a feared complication of cataract surgery. Current literature on wipe-out is limited in quantity and quality, and largely predates modern cataract surgery and imaging techniques. The objectives of our study were to estimate the incidence of wipe-out and to identify potential risk factors.
METHODS
METHODS
We prospectively collated cases of wipe-out occurring in the UK during a 25-month study period using the British Ophthalmic Surveillance Unit reporting system. A total of 21 potential cases of wipe-out were reported, 5 of which met all inclusion and exclusion criteria.
RESULTS
RESULTS
The estimated incidence of wipe-out during the study period was 0.00000298, or approximately 3 cases per million cataract operations. All cases of wipe-out occurred exclusively in patients with advanced glaucoma (mean deviation -21.0 decibels or worse in the operated eye), with an over-representation of black people (40%) in our case series. A prior diagnosis of retinal vein occlusion (60%) and elevated post-operative IOP (40%) were more common among individuals suffering from wipe-out compared to the general population, suggesting these factors may contribute to the pathogenesis of wipe-out.
CONCLUSIONS
CONCLUSIONS
Our study shows that wipe-out is a rare complication, affecting approximately 3 per million undergoing cataract surgery. Patients with advanced glaucoma, black patients, and those with previous retinal vein occlusions may be at greater risk of wipe-out. We hope that the findings of our study will be used to help inform treatment decision-making and the cataract surgery consent process.
Identifiants
pubmed: 37328508
doi: 10.1038/s41433-023-02606-9
pii: 10.1038/s41433-023-02606-9
pmc: PMC10697986
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3787-3792Informations de copyright
© 2023. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.
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