Incidence and Risk Factors for Rebound Inflammation After Cataract Surgery Performed by Surgeons in Training

Sunday, April 19, 2015: 1:56 PM
Room 5A (San Diego Convention Center)
Megha Agrawal, MD
Sumitra Khandelwal, MD
Silvia Orengo-Nania, MD
Kristin Schmid, MD
Robert E. Coffee, MD

Purpose
To evaluate the incidence and risk factors for rebound inflammation following uncomplicated cataract surgery performed by surgeons in training.

Methods
In this retrospective case series, we review all cataract surgeries performed by surgeons-in-training between January 2014 and June 2014. Pre-operative factors evaluated include pre-operative uveitis, pupil status, and density of lens. Intraoperative factors include phacoemulsification time, operative time, use of iris expansion devices, and administration of subconjunctival steroids at the end of the case. Post-operative factors include anti-inflammatory medications prescribed, patient compliance, concurrent use of other ocular medications, and any post-operative findings.  A logistic regression model will be performed to determine factors affecting rebound inflammation.

Results
The charts of 300 patients were reviewed. A total of 22 cases of rebound inflammation, defined as persistent or recurrent inflammation 30 days or more after surgery resulting in further treatment, were identified. The average age of the patients who experienced rebound inflammation was 72 years, with a range of 60-92 years. All of the patients identified were male. The average operating time was 46 minutes, with a minimum of 13 minutes and a maximum of 183 minutes. The average cumulative dissipated energy (CDE) was 22.52, with a range of 5.99 to 113.8.

Conclusion
We will further determine the factors contributing to rebound inflammation after uncomplicated cataract surgery performed by surgeons-in-training with comparisons against matched controls. Based on this data, surgical technique and post-operative care may be modified to decrease the incidence of post-operative rebound inflammation in this patient population.