3333 Phacoemulsification in older adults: a systematic review

Abstract Introduction Phacoemulsification is a widely used cataract surgery technique, particularly in older adults, offering significant improvements in vision and quality of life. As the global population ages, understanding the outcomes and risks of this procedure in elderly individuals becomes increasingly important. This review aims to assess the safety, efficacy, and potential complications of phacoemulsification in older adults. Method A search was conducted across three databases—PubMed, Scopus, and Cochrane—for studies published between 2020 and 2025. Inclusion criteria were studies focusing on phacoemulsification in older adults, reporting on clinical outcomes, safety, and efficacy. Only peer-reviewed, full-text, and English-language articles were considered. From an initial pool of 376 papers, 41 were selected for review based on relevance and quality of evidence. Results The findings demonstrated a significant enhancement in best-corrected visual acuity (BCVA) following surgery, with a majority of patients achieving 20/40 or better within weeks of the procedure. Functional vision improvements were observed across various daily activities, including reading, mobility, and overall quality of life. Complication rates remained relatively low, with posterior capsular opacification (PCO) being the most common long-term issue, requiring subsequent Nd:YAG laser capsulotomy. Other complications, such as transient intraocular pressure elevation and corneal edema, were typically mild and self-limiting. Patients with pre-existing conditions such as diabetes, glaucoma, and age-related macular degeneration exhibited slightly higher complication rates but still benefited significantly from the procedure. Although recovery times were generally similar to those in younger populations, some studies indicated delayed neuroadaptation in older adults, particularly in those receiving multifocal IOLs. Despite this, patient satisfaction remained high, with most individuals reporting increased independence and an improved quality of life. Conclusion Phacoemulsification in older adults shows promising results, with minimal complications and high satisfaction. The procedure enhances independence, with advancements in techniques further improving outcomes and reducing risks.