Risk factors for complications during phacoemulsification cataract surgery

Introduction Modern day phacoemulsification has a high level of predictability and safety of surgical outcomes. Various risk factors predispose to the development of intraoperative complications and assessment of potential risk factors prior to surgery can help the surgeon to anticipate potential complications and modify the surgical plan to achieve optimal postoperative outcomes.Areas covered We herein discuss the risk factors that may predispose to the development of intraoperative complications, preventive measures, and brief management. A comprehensive Medline search was performed using ‘phacoemulsification’, ‘complications’, ‘risk factors phacoemulsification’, ‘cataract surgery complications’ and ‘complications femtosecond laser-assisted cataract surgery’ as keywords. The risk factors for developing intraoperative complications may be related to surgeon inexperience, environment (including machine and instruments) and the patient (systemic and ocular status). Comprehensive preoperative assessment and surgical planning can help minimize the incidence of complications in these cases.Expert opinion There has been a decrease in the incidence of complications over the past decades due to technological advancements, enhanced understanding of the dynamics of phacoemulsification and fluidics and better skill-transfer to surgeons. In addition to modifiable risk factors related to surgeon experience and machinery, there are non-modifiable risk factors related to complicated and challenging cataract cases.