# Ethnic Differences in the Rates of Posterior Capsule Rupture and Long-Term Sequelae in Phacoemulsification Cataract Surgery

## TL;DR

This study finds that posterior capsule rupture during cataract surgery occurs more frequently in certain ethnic groups, suggesting ethnicity could influence surgical risk.

## Contribution

The study is the first to show a possible link between patient ethnicity and posterior capsule rupture risk during cataract surgery.

## Key findings

- Posterior capsule rupture rates were highest in African-Caribbean patients (1.8%) and lowest in Caucasians (0.7%).
- Post-operative uveitis rates varied significantly among ethnic groups, with Indian subcontinent patients having the highest rate (15.7%).
- Visual acuity improved in all ethnic groups after surgery, but complication rates like cystoid macular oedema did not differ significantly.

## Abstract

Purpose

The purpose of this study is to investigate the rates of posterior capsular rupture (PCR) and its sequelae during phacoemulsification across different ethnicities.

Methods

This is a retrospective cohort study of all consecutive phacoemulsification cases complicated by PCR that met the inclusion criteria over a four-year period at a single tertiary eye centre in the United Kingdom (UK).

Results

PCR occurred in 0.85% of cases overall (157/18,481). PCR rates were 1.8% (26/1485), 1.2% (51/4350), and 0.7% (75/10,927) in African-Caribbean, Indian subcontinent, and Caucasian patients, respectively (p < 0.001). Mean final corrected distance visual acuity improved (p < 0.05) in all ethnic groups (0.40 ± 0.57 logMAR) compared to pre-op (0.78 ± 0.61 logMAR). Post-operative cystoid macular oedema and unstable intraocular pressure rates following PCR did not statistically differ amongst ethnicities (p = 0.37 and p = 0.75, respectively). However, post-operative uveitis rates significantly differed at 11.5%, 15.7%, and 1.3% amongst the three ethnic groups, respectively (p = 0.01).

Conclusion

This is the first study to highlight a possible link between patient ethnicity and the risk of PCR during phacoemulsification cataract surgery. We observed significantly greater numbers of PCR cases amongst certain ethnic groups (highest in African-Caribbean eyes, then Indian subcontinental eyes, and lowest in Caucasian eyes) within the same multi-cultural urban population. Ethnicity may therefore be a contributing factor for PCR and should potentially be taken into consideration during preoperative risk stratification.