Ten-Year Experience with Cataract Surgery and Associated Complications in Albania

Abstract

Cataract remains a leading cause of visual impairment worldwide, and surgical intervention is the only effective treatment. In Albania, limited data exist regarding long-term outcomes and postoperative complications. This retrospective study evaluated 5,700 cataract surgeries performed at a major Albanian eye center between 2013 and 2023, focusing on surgical techniques, risk factors, and management of patients with ocular comorbidities. Both phacoemulsification and extracapsular cataract extraction (ECCE) were included. Data were collected on patient demographics, systemic and ocular comorbidities, type of anesthesia, surgical technique, intraoperative events, and postoperative complications, including posterior capsule rupture, corneal edema, elevated intraocular pressure, cystoid macular edema, and endophthalmitis. Statistical analyses assessed the incidence of complications and their association with surgical factors. Phacoemulsification was the predominant technique, accounting for 90% of cases, and was associated with a lower overall complication rate (4.3%) compared to ECCE (11.6%). Posterior capsule rupture was the most frequent complication (2.3%), while endophthalmitis was extremely rare (0.05%). A considerable proportion of patients presented with systemic or ocular comorbidities, including diabetes (16%) and wet age-related macular degeneration (4%), and combined cataract surgery with intravitreal injections was successfully performed in selected high-risk patients to optimize visual outcomes. These findings indicate that modern cataract surgery in Albania is safe and effective, particularly when phacoemulsification is employed. Careful preoperative assessment, meticulous surgical technique, and individualized management of patients with comorbidities are crucial for minimizing complications and optimizing postoperative visual function. Overall, this ten-year experience provides important benchmarks for cataract surgical practice in Albania and similar clinical settings, highlighting the benefits of advanced surgical techniques and tailored perioperative care for improving patient outcomes.