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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