Risk factors affecting visual outcomes following dropped nucleus after cataract surgery

Background/ Aims To describe the visual outcomes in eyes with dropped nucleus during phacoemulsification surgery. Setting Singapore National Eye Centre (SNEC). Design Retrospective chart review of prospectively reported cases of dropped nucleus. Methods The clinical charts of all cases of dropped nucleus (Jan 2001 to Dec 2016) were retrospectively reviewed for patient demographics, surgeon type, stage of surgery, timing of pars plana vitrectomy (PPV), and complications. Visual success was defined as best corrected visual acuity (BCVA) ≥ 20/40 at last review. Final risk factors affecting visual success were identified using multivariate logistic regression analysis. Results Incidence of dropped nucleus following cataract surgery was 0.17% ( n = 292). Duration of follow-up was 25.5 months (mean), 18.5 months (median). There was a statistically significant difference in dropped nucleus rate between Residents (0.3%) and Faculty (0.14%) (x 2 = 38.2, P 70 years, absence of intraocular lens (IOL) implant, and presence of major complications. Conclusion Overall incidence of dropped nucleus in SNEC was 0.17%, with BCVA of 20/40 or better in 85.2% cases. Visual prognosis was influenced by patient’s age, presence of IOL implant or additional major complications.