Determinants of Reoperation Following Cataract Surgery: A Real-World Analysis From a Large Tertiary Training Eye Hospital in Iran Publisher Pubmed



Farrokhpour H ; Ashrafi E ; Mehravaran S ; Sadeghi R ; Mohammadi SF
Source: International Ophthalmology Published:2025

Abstract

Purpose: We aimed to evaluate the rate and determinants of reoperation after age-related cataract surgery and its potential risk factors. Methods: In this retrospective case-cohort study conducted at a tertiary eye hospital, Tehran, Iran, a representative sample of patients with cataract surgery from March 2017 to March 2021 was randomly selected from the hospital's medical records and reviewed for returns to the operating room during the first year after the procedure. Demographics, ocular characteristics, and operative factors of patients with reoperation were reviewed, and 3 randomly selected patients with a history of the same-day surgery for each reoperation case were designated as the controls. Potential risk factors were compared using multivariable logistic regression. Results: Among the included 4666 surgery records, 70 reoperations related to 63 eyes (1.52%) were detected, with the reoperation rates of 0.75% for attendings and fellowship surgeons, and 3.57% for residents in training. Aphakia (20.0%), endophthalmitis (15.7%), and rhegmatogenous retinal detachment (14.3%) were the most common reasons for reoperations. After adjusting for potential confounders among the 70 reoperations and 211 controls, posterior capsular rupture (PCR), blepharitis and/or meibomian gland dysfunction (MGD), and axial length < 22.0 or > 24.5mm were significantly associated with reoperation. Conclusion: The total reoperation rate was 1.52%. PCR was a major determinant of these reoperations. Other factors included axial length < 22.0 or > 24.5mm and pathologies with high impact on the ocular surface, like MGD and blepharitis. © 2025 Elsevier B.V., All rights reserved.