International Ophthalmology

, Volume 38, Issue 5, pp 1851–1861 | Cite as

The evaluation of the risk factors for capsular complications in phacoemulsification

  • Şule Berk Ergun
  • Sücattin İlker KocamışEmail author
  • Hasan Basri Çakmak
  • Nurullah Çağıl
Original Paper



To determine and quantify the risk factors for disruption of lens capsule integrity during phacoemulsification.


The medical records of the patients who had undergone phacoemulsification cataract surgery and had a complication associated with lens capsule were reviewed. Consecutive cases were also reviewed in reverse chronological order as a control group. The exclusion criteria were pediatric cataracts, traumatic cataracts and lens dislocation. As a result, 403 uncomplicated and 83 complicated eyes were analyzed. The differences between the complication group and the group without complications regarding the risk factors were shown by employing the Chi-square test and Fischer’s exact test. The variables having the level of significance (p < 0.25) after the Chi-square test and Fischer’s exact test were enrolled into the multiple stepwise logistic regression analysis.


Age (60–69/≤80) (p = 0.017), male gender (p = 0.006), pupil size ≤3 mm (p = <0.001), mature–brunescent cataract (p = <0.001), anterior chamber depth <2.5 mm (p = 0.001), posterior polar cataract (p = 0.006), diabetic retinopathy(p = <0.001), coronary artery disease (p = 0.098) and surgeon factor (junior resident/senior resident, p = 0.015; senior resident/specialist in ophthalmology, p = 0.026; junior resident/specialist in ophthalmology, p = 0.020) were among the factors significantly related to a capsule complication. An Excel program has been developed according to these results to predict the probability of capsule complication.


Higher-risk cases can be predicted preoperatively, thus allowing surgeons to take appropriate precautions, better informing the patient and better selecting the cases especially for trainee surgeons.


Lens capsule integrity Phacoemulsification Posterior capsular rupture Risk factors 


Compliance with ethical standards

Conflict of interest

Authors state that there is no conflict of interest.


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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Şule Berk Ergun
    • 1
  • Sücattin İlker Kocamış
    • 2
    • 4
    Email author
  • Hasan Basri Çakmak
    • 2
  • Nurullah Çağıl
    • 3
  1. 1.Department of OphthalmologyNumune Training and Research HospitalAnkaraTurkey
  2. 2.Department of Ophthalmology, Faculty of MedicineHitit UniversityÇorumTurkey
  3. 3.Department of Ophthalmology, Faculty of MedicineYıldırım Beyazıt UniversityAnkaraTurkey
  4. 4.Bahçelievler Mah. Melikgazi CadÇorumTurkey

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