No significant difference in intraoperative complications between LEP and EP cataract surgery (2.0% vs 1.6%)

Description #

There was no statistically significant difference in intraoperative complications between LEP and EP cataract surgeries (any intraoperative complication 2.0% vs 1.6%, P = .349) (Table 2). Individual complications (posterior capsular rupture, vitreous loss, retained lens, zonular dialysis, choroidal hemorrhage) were also not significantly different. This is a null result.

"There were no statistically significant differences in operative time, intraoperative complications such as posterior capsular rupture, vitreous loss, retained lens material, zonular dialysis, or choroidal hemorrhage." (Zafar, 2023, p. 598)

"Any of these intraop complications 17 (2.0) 197 (1.6) .349" (Zafar, 2023, p. 597, Table 2)

Methods Context #

What? #ⓘ

The observable: intraoperative complications during cataract surgery, recorded as categorical events.

"Where intraoperative complications include PCR, vitreous loss, retained lens, zonular dialysis, or choroidal hemorrhage" (Zafar, 2023, p. 597, Table 2)

How? #ⓘ

Retrospective comparison by LEP status using logistic regression with generalized estimating equations to account for correlation between fellow eyes.

"Comparisons by LEP status were analyzed using logistic regression with generalized estimating equations to account for correlation between eyes from the same subject." (Zafar, 2023, p. 596)

Who? #ⓘ

13,590 phacoemulsification eyes at a single academic eye center (2014–2020); 868 (6.4%) LEP vs 12,722 EP. Serious complications were rare in both groups.

"A total of 13 590 eyes were included in the analytic database. Of these, 868 (6.4%) were identified from LEP patients." (Zafar, 2023, p. 596)

Caveats #

• Small LEP sample underpowered to detect differences, especially rare complications (Zafar cataract) The LEP group (n = 868 eyes) was far smaller than the EP group (n = 12,722), and the authors state the small LEP sample limited their ability to detect further significant differences. They specifically note that serious complications such as endophthalmitis and IOL dislocation were too infrequent for the study to be adequately powered to detect between-group differences. The non-significant (null) findings for intraoperative complications, operative time, and postoperative complications should therefore be read as inconclusive rather than as demonstrated equivalence.