Incidence of Non-arteritic Ischemic Optic Neuropathy Following Topical Clear Corneal Cataract Surgery
Cataract, non arteritic ischemic optic neuropathy:-
The primary objective was to evaluate the incidence and characteristics of post-cataract-surgery nonarteritic ischemic optic neuropathy (PCNAION) after topical clear corneal cataract extraction (CCCE) in Canada.
Design:-Canada-wide internet survey and meta-analysis
Material and methods:-
All certified Canadian ophthalmologists in the Canadian Ophthalmological Society directory, or belonging to a provincial ophthalmology internet group.
Identical surveys were distributed to 5 regions in Canada.
CCCE surgeons were asked to estimate the number of CCCE they had performed in their career, and the number of PCNAION events that occurred within 1 year after CCCE.
The results were analyzed using a random effects meta-analysis of proportions for rare events.
The estimated survey response rate was 18%–32%. 26 percent of surgeons had at least one patient with PCNAION. Meta-analysis revealed a pooled estimate incidence of 2.8 PCNAION events (95% confidence interval 1.6–4.7) per 100 000 cataract procedures during the year after cataract surgery. 77 percent (82/107) of the PCNAION cases occurred within 3 weeks of surgery, and 7 patients had bilateral PCNAION.
Conclusion:- PCNAION is a rare complication after topical CCCE. Its incidence is important to estimate for patient care and epidemiologic reasons
In this survey of cataract surgeons in Canada who performed topical clear corneal cataract extraction and a subsequent meta-analysis of the survey responses, the authors found a low incidence (2.8 per 100,000 surgeries) of post–cataract surgery nonarteritic ischemic optic neuropathy (PCNAION).
Overall, 77% (82/107) of PCNAION cases occurred within the first 3 weeks of surgery, and 39% (32/82) of these cases had an intraocular pressure higher than 28 mm Hg within the first 3 days after the cataract surgery.
Can J Ophthalmol 2019 Aug 09;[EPub Ahead of Print], EB Ing, JWK Kam, JZ Cheng, SWK Wong, H Strungaru, A Slomovic, L Weisbrod, N Torun