The probable associations for corticocapsular adhesions in patients undergoing cataract surgery: A clinic-based observational study

BACKGROUND: Corticocapsular adhesions (CCA) are frequently seen between lens capsule and adjacent cortical layer. During cataract surgery, in the presence of CCA, excessive efforts to rotate the nucleus can result in zonular damage. To reduce morbidity, identification of associations with CCA can be helpful in appropriately modifying the surgical procedure. AIM: To investigate probable associations with CCA in patients undergoing cataract surgery. SETTING AND DESIGN: Iladevi Cataract and IOL research center. Case-control study. MATERIALS AND METHODS: A single eye of 600 patients, 200 patients with CCA (cases) and 400 patients without CCA (controls) were considered. A CCA diagnosis was based on: (i) preoperative presence of CCA on slit- lamp examination with visualization of furry surface of cortex during surgery; (ii) preoperative absence of CCA on slit-lamp examination but intraoperative visualization of furry surface of cortex. Variables such as age, gender, type of cataract, grade of cataract, high myopia, diabetes mellitus and hypertension were studied. STATISTICAL ANALYSIS: Multivariate logistic regression was done. Results were presented as odds ratio (OR) with 95% CI. RESULTS: Mean age was 64.71 ± 9.10 years in cases and 59.27 ± 8.79 years in controls. Presence of CCA increased with age from 22% (n = 59) in 45 to 49 years to 70% (n = 110) in 70 to 79 years. An increase in age was associated with CCA by 3.3% (OR = 3.3%, P = 0.028). The odds of CCA for females were 83% higher (P = 0.027). Presence of anterior cortical cataract increased odds of CCA by 9.5 times (P = 0.001), while posterior cortical cataract increased odds by 3.3 times (P = 0.001). CONCLUSION: Corticocapsular adhesions were strongly associated with cortical cataracts, increased age and female gender.