Prevalence and predictors of ocular complications associated with cataract surgery in United States veterans

Paul B. Greenberg, Victoria L. Tseng, Wen Chih Wu, Jeffrey Liu, Lan Jiang, Christine K. Chen, Ingrid U. Scott, Peter D. Friedmann

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Abstract

Purpose To investigate the prevalence and predictors of intraoperative and 90-day postoperative ocular complications associated with cataract surgery performed in the United States Veterans Health Administration (VHA) system. Design Retrospective cohort study. Participants Forty-five thousand eighty-two veterans who underwent cataract surgery in the VHA. Methods The National Patient Care Database was used to identify all VHA patients who underwent outpatient extracapsular cataract surgery and who underwent only 1 cataract surgery within 90 days of the index surgery between October 1, 2005, and September 30, 2007. Data collected include demographics, preoperative systemic and ocular comorbidities, intraoperative complications, and 90-day postoperative complications. Adjusted odds ratios (ORs) of factors predictive of complications were calculated using logistic regression modeling. Main Outcome Measures Intraoperative and postoperative ocular complications within 90 days of cataract surgery. Results During the study period, 53 786 veterans underwent cataract surgery; 45 082 met inclusion criteria. Common preoperative systemic and ocular comorbidities included diabetes mellitus (40.6%), chronic pulmonary disease (21.2%), age-related macular degeneration (14.4%), and diabetes with ophthalmic manifestations (14.0%). The most common ocular complications were posterior capsular tear, anterior vitrectomy, or both during surgery (3.5%) and posterior capsular opacification after surgery (4.2%). Predictors of complications included: black race (OR, 1.38; 95% confidence interval [CI], 1.281.50), divorced status (OR, 1.10; 95% CI, 1.031.18), never married (OR, 1.26; 95% CI, 1.141.38), diabetes with ophthalmic manifestations (OR, 1.33; 95% CI, 1.231.43), traumatic cataract (OR, 1.80; 95% CI, 1.402.31), previous ocular surgery (OR, 1.29; 95% CI, 1.021.63), and older age. Conclusions In a cohort of United States veterans with a high preoperative disease burden, selected demographic factors and ocular comorbidities were associated with greater risks of cataract surgery complications. Further large-scale studies are warranted to investigate cataract surgery outcomes for non-VHA United States patient populations. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Original languageEnglish (US)
Pages (from-to)507-514
Number of pages8
JournalOphthalmology
Volume118
Issue number3
DOIs
StatePublished - Mar 1 2011

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Veterans
Cataract
Odds Ratio
Confidence Intervals
Veterans Health
United States Department of Veterans Affairs
Eye Manifestations
Comorbidity
Ambulatory Surgical Procedures
Demography
Divorce
Vitrectomy
Intraoperative Complications
Disclosure
Macular Degeneration
Tears
Lung Diseases
Patient Care
Diabetes Mellitus
Chronic Disease

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Greenberg, P. B., Tseng, V. L., Wu, W. C., Liu, J., Jiang, L., Chen, C. K., ... Friedmann, P. D. (2011). Prevalence and predictors of ocular complications associated with cataract surgery in United States veterans. Ophthalmology, 118(3), 507-514. https://doi.org/10.1016/j.ophtha.2010.07.023
Greenberg, Paul B. ; Tseng, Victoria L. ; Wu, Wen Chih ; Liu, Jeffrey ; Jiang, Lan ; Chen, Christine K. ; Scott, Ingrid U. ; Friedmann, Peter D. / Prevalence and predictors of ocular complications associated with cataract surgery in United States veterans. In: Ophthalmology. 2011 ; Vol. 118, No. 3. pp. 507-514.
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title = "Prevalence and predictors of ocular complications associated with cataract surgery in United States veterans",
abstract = "Purpose To investigate the prevalence and predictors of intraoperative and 90-day postoperative ocular complications associated with cataract surgery performed in the United States Veterans Health Administration (VHA) system. Design Retrospective cohort study. Participants Forty-five thousand eighty-two veterans who underwent cataract surgery in the VHA. Methods The National Patient Care Database was used to identify all VHA patients who underwent outpatient extracapsular cataract surgery and who underwent only 1 cataract surgery within 90 days of the index surgery between October 1, 2005, and September 30, 2007. Data collected include demographics, preoperative systemic and ocular comorbidities, intraoperative complications, and 90-day postoperative complications. Adjusted odds ratios (ORs) of factors predictive of complications were calculated using logistic regression modeling. Main Outcome Measures Intraoperative and postoperative ocular complications within 90 days of cataract surgery. Results During the study period, 53 786 veterans underwent cataract surgery; 45 082 met inclusion criteria. Common preoperative systemic and ocular comorbidities included diabetes mellitus (40.6{\%}), chronic pulmonary disease (21.2{\%}), age-related macular degeneration (14.4{\%}), and diabetes with ophthalmic manifestations (14.0{\%}). The most common ocular complications were posterior capsular tear, anterior vitrectomy, or both during surgery (3.5{\%}) and posterior capsular opacification after surgery (4.2{\%}). Predictors of complications included: black race (OR, 1.38; 95{\%} confidence interval [CI], 1.281.50), divorced status (OR, 1.10; 95{\%} CI, 1.031.18), never married (OR, 1.26; 95{\%} CI, 1.141.38), diabetes with ophthalmic manifestations (OR, 1.33; 95{\%} CI, 1.231.43), traumatic cataract (OR, 1.80; 95{\%} CI, 1.402.31), previous ocular surgery (OR, 1.29; 95{\%} CI, 1.021.63), and older age. Conclusions In a cohort of United States veterans with a high preoperative disease burden, selected demographic factors and ocular comorbidities were associated with greater risks of cataract surgery complications. Further large-scale studies are warranted to investigate cataract surgery outcomes for non-VHA United States patient populations. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.",
author = "Greenberg, {Paul B.} and Tseng, {Victoria L.} and Wu, {Wen Chih} and Jeffrey Liu and Lan Jiang and Chen, {Christine K.} and Scott, {Ingrid U.} and Friedmann, {Peter D.}",
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Greenberg, PB, Tseng, VL, Wu, WC, Liu, J, Jiang, L, Chen, CK, Scott, IU & Friedmann, PD 2011, 'Prevalence and predictors of ocular complications associated with cataract surgery in United States veterans', Ophthalmology, vol. 118, no. 3, pp. 507-514. https://doi.org/10.1016/j.ophtha.2010.07.023

Prevalence and predictors of ocular complications associated with cataract surgery in United States veterans. / Greenberg, Paul B.; Tseng, Victoria L.; Wu, Wen Chih; Liu, Jeffrey; Jiang, Lan; Chen, Christine K.; Scott, Ingrid U.; Friedmann, Peter D.

In: Ophthalmology, Vol. 118, No. 3, 01.03.2011, p. 507-514.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prevalence and predictors of ocular complications associated with cataract surgery in United States veterans

AU - Greenberg, Paul B.

AU - Tseng, Victoria L.

AU - Wu, Wen Chih

AU - Liu, Jeffrey

AU - Jiang, Lan

AU - Chen, Christine K.

AU - Scott, Ingrid U.

AU - Friedmann, Peter D.

PY - 2011/3/1

Y1 - 2011/3/1

N2 - Purpose To investigate the prevalence and predictors of intraoperative and 90-day postoperative ocular complications associated with cataract surgery performed in the United States Veterans Health Administration (VHA) system. Design Retrospective cohort study. Participants Forty-five thousand eighty-two veterans who underwent cataract surgery in the VHA. Methods The National Patient Care Database was used to identify all VHA patients who underwent outpatient extracapsular cataract surgery and who underwent only 1 cataract surgery within 90 days of the index surgery between October 1, 2005, and September 30, 2007. Data collected include demographics, preoperative systemic and ocular comorbidities, intraoperative complications, and 90-day postoperative complications. Adjusted odds ratios (ORs) of factors predictive of complications were calculated using logistic regression modeling. Main Outcome Measures Intraoperative and postoperative ocular complications within 90 days of cataract surgery. Results During the study period, 53 786 veterans underwent cataract surgery; 45 082 met inclusion criteria. Common preoperative systemic and ocular comorbidities included diabetes mellitus (40.6%), chronic pulmonary disease (21.2%), age-related macular degeneration (14.4%), and diabetes with ophthalmic manifestations (14.0%). The most common ocular complications were posterior capsular tear, anterior vitrectomy, or both during surgery (3.5%) and posterior capsular opacification after surgery (4.2%). Predictors of complications included: black race (OR, 1.38; 95% confidence interval [CI], 1.281.50), divorced status (OR, 1.10; 95% CI, 1.031.18), never married (OR, 1.26; 95% CI, 1.141.38), diabetes with ophthalmic manifestations (OR, 1.33; 95% CI, 1.231.43), traumatic cataract (OR, 1.80; 95% CI, 1.402.31), previous ocular surgery (OR, 1.29; 95% CI, 1.021.63), and older age. Conclusions In a cohort of United States veterans with a high preoperative disease burden, selected demographic factors and ocular comorbidities were associated with greater risks of cataract surgery complications. Further large-scale studies are warranted to investigate cataract surgery outcomes for non-VHA United States patient populations. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

AB - Purpose To investigate the prevalence and predictors of intraoperative and 90-day postoperative ocular complications associated with cataract surgery performed in the United States Veterans Health Administration (VHA) system. Design Retrospective cohort study. Participants Forty-five thousand eighty-two veterans who underwent cataract surgery in the VHA. Methods The National Patient Care Database was used to identify all VHA patients who underwent outpatient extracapsular cataract surgery and who underwent only 1 cataract surgery within 90 days of the index surgery between October 1, 2005, and September 30, 2007. Data collected include demographics, preoperative systemic and ocular comorbidities, intraoperative complications, and 90-day postoperative complications. Adjusted odds ratios (ORs) of factors predictive of complications were calculated using logistic regression modeling. Main Outcome Measures Intraoperative and postoperative ocular complications within 90 days of cataract surgery. Results During the study period, 53 786 veterans underwent cataract surgery; 45 082 met inclusion criteria. Common preoperative systemic and ocular comorbidities included diabetes mellitus (40.6%), chronic pulmonary disease (21.2%), age-related macular degeneration (14.4%), and diabetes with ophthalmic manifestations (14.0%). The most common ocular complications were posterior capsular tear, anterior vitrectomy, or both during surgery (3.5%) and posterior capsular opacification after surgery (4.2%). Predictors of complications included: black race (OR, 1.38; 95% confidence interval [CI], 1.281.50), divorced status (OR, 1.10; 95% CI, 1.031.18), never married (OR, 1.26; 95% CI, 1.141.38), diabetes with ophthalmic manifestations (OR, 1.33; 95% CI, 1.231.43), traumatic cataract (OR, 1.80; 95% CI, 1.402.31), previous ocular surgery (OR, 1.29; 95% CI, 1.021.63), and older age. Conclusions In a cohort of United States veterans with a high preoperative disease burden, selected demographic factors and ocular comorbidities were associated with greater risks of cataract surgery complications. Further large-scale studies are warranted to investigate cataract surgery outcomes for non-VHA United States patient populations. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

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