Study highlights wound burn risk and risk factors

April 19 - Washington, DC - Significant wound burn occurs in about 1 in 1,000 cases of phacoemulsification, but its incidence is influenced by surgical technique, reported Randall J. Olson, MD.

Data on clinically important wound burns were collected through a Web-based questionnaire from surgeons in five Western states. A total of 106 responses were received, representing about 76,500 cases of cataract removal by phacoemulsification. There were 75 cases of wound burn reported. Of those, 53 (71%) occurred during fragment removal, and occlusion was recognized by the surgeon in 24 (32%) cases.

Multivariate analyses revealed that use of continuous power and a divide-and-conquer technique were significant risk factors for wound burn. Use of ultrapulse power modulation with Sovereign WhiteStar (AMO) and a chop approach, particularly vertical chop, were highly protective.

The rate of wound burn associated with the WhiteStar procedure was 0.026% compared with 0.18% for surgeries performed with continuous power. Wound burn occurred during 0.026% of cases performed using a vertical chop approach compared with 0.13% of those employing divide and conquer.

"I am not aware of any other study with such a larger number of wound burns, and this dataset allowed us to analyze risk factors. I believe wound burn is a preventable problem and that we should be looking more carefully into the effects of power modulations and technique," Dr. Olson said.

Dr. Olson is a consultant to AMO but received no financial support for this study.