Resultados Visuales y Complicaciones de la Facoemulsificación en Cirugía de Catarata: Revisión Sistemática
Palabras clave:
catarata, facoemulsificación, resultados visuales, complicaciones quirúrgicas, cirugía de catarata, revisión sistemática
Resumen
Introducción: La catarata constituye una de las principales causas de discapacidad visual reversible a nivel mundial, y la facoemulsificación se ha consolidado como la técnica quirúrgica de referencia para su tratamiento debido a sus favorables resultados visuales y perfil de seguridad. El objetivo de esta revisión sistemática fue sintetizar la evidencia disponible sobre los resultados visuales y las complicaciones asociadas a la facoemulsificación en cirugía de catarata. Metodología: Se incluyeron revisiones sistemáticas, metaanálisis, estudios observacionales y cohortes relacionados con resultados visuales, seguridad quirúrgica y complicaciones intraoperatorias y postoperatorias de la facoemulsificación. La información fue organizada por categorías temáticas, incluyendo recuperación visual, complicaciones quirúrgicas y factores clínicos asociados. Resultados: La evidencia revisada mostró que la facoemulsificación proporciona mejoría significativa de la agudeza visual y recuperación funcional favorable en la mayoría de los pacientes operados [4,5,8]. Asimismo, los estudios comparativos sugieren resultados visuales comparables o superiores frente a técnicas convencionales como la extracción extracapsular [8]. Entre las principales complicaciones identificadas se encontraron ruptura de cápsula posterior, hipertensión ocular, desprendimiento de retina, endoftalmitis y hemorragia supracoroidea [7,9,16,21,23,24]. La presencia de diabetes mellitus, uveítis, catarata compleja y debilidad zonular se relacionó con mayor riesgo de resultados visuales subóptimos o complicaciones quirúrgicas [10,14,18,20,23]. Conclusiones: La facoemulsificación representa una técnica efectiva y segura para la cirugía de catarata, aunque los resultados visuales y el riesgo de complicaciones dependen de múltiples factores clínicos y quirúrgicos. Se requieren estudios prospectivos con desenlaces estandarizados para fortalecer la evidencia disponible.
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1. Gurnani B, Kaur K. Phacoemulsification [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK576419/
2. Welch Ruiz G, Cruz Blanco M, Escalona Tamayo M de J, Fundora Salgado V. Facoemulsificación en la cirugía de catarata. Revista Cubana de Medicina Militar [Internet]. 2017 Sep 1;46(3):244–55. Available from: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-65572017000300005
3. Álvarez-Rementería Fernández L. Complicaciones durante la facoemulsificación [Internet]. Available from: https://secoir.org/wp-content/uploads/2022/09/2016-Cap-21-Complicaciones-durante-la-facoemulsificacion.pdf
4. Mayor Orezime Atima, Ugbede Idakwo, Oyeronke Komolafe, Shimizu E, Nakayama Shintaro, Emmanuel Oluwadare Balogun, et al. Long‐Term Outcomes of Phacoemulsification Surgeries at ECWA Eye Hospital: A Prospective Clinical Cohort Study. Journal of Ophthalmology. 2024 Jan 1;2024(1).
5. Villanueva-Nájera MÁ, Herrero-Herrera S. Resultados visuales en pacientes operados de facoemulsificación con implante de lente intraocular libre de microvacuolas en el Hospital General de México. Revista Mexicana de Oftalmología. 2015 Oct;89(4):205–9.
6. Cicinelli MV, Buchan JC, Nicholson M, Varadaraj V, Khanna RC. Cataracts. The Lancet [Internet]. 2023 Feb;401(10374):377–89. Available from: https://pubmed.ncbi.nlm.nih.gov/36565712/
7. Qureshi MH, Steel DHW. Retinal detachment following cataract phacoemulsification—a review of the literature. Eye [Internet]. 2019 Oct 1;34(4):616–31. Available from: https://pubmed.ncbi.nlm.nih.gov/31576027/
8. Li A, He Q, Wei L, Chen Y, He S, Zhang Q, et al. Comparison of visual acuity between phacoemulsification and extracapsular cataract extraction: a systematic review and meta-analysis. Annals of Palliative Medicine. 2022 Feb;11(2):551–9.
9. Aguilar C, Ramos S, Eric MD, Puertas, H, Eneida C, Cárdenas Díaz, Taimi. Factores asociados a la hipertensión ocular después de una facoemulsificación no complicada. Revista Cubana de Oftalmología [Internet]. 2018 [cited 2026 Apr 21];31(2):1–11. Available from: http://scielo.sld.cu/scielo.php?pid=S0864-21762018000200006&script=sci_arttext
10. Siamak Zarei-Ghanavati, Hadi Y, Habibi A, Khorasani MA, Yoo SH. Cataract and Diabetes: a review of the literature. Journal of Cataract & Refractive Surgery [Internet]. 2024 Sep 9; Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11556822/
11. Bhagat PR, Prajapati KM. Manual small-incision cataract surgery and glaucoma – A dilemma of the duo. Indian Journal of Ophthalmology. 2022 Nov;70(11):3797–802.
12. Song X, Li L, Zhang X, Ma J. Comparing the efficacy and safety between femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery: systematic review and meta-analysis. Canadian journal of ophthalmology Journal canadien d’ophtalmologie [Internet]. 2025 Feb;60(1):e1–10. Available from: https://pubmed.ncbi.nlm.nih.gov/39043258/
13. Bhagat N, Nissirios N, Potdevin L, Chung J, Lama P, Zarbin MA, et al. Complications in resident-performed phacoemulsification cataract surgery at New Jersey Medical School. British Journal of Ophthalmology [Internet]. 2007 Oct 1;91(10):1315–7. Available from: https://bjo.bmj.com/content/91/10/1315.short?casa_token=2marpJZLjEUAAAAA:dR8BLczYqE9PVt4DPHZe9Y8AGo2lPS1zv2wbtJ0X9BX16gSuRGv5EFywpqtpwifvrOxOhJ6w49r9rZ1T
14. Sorin Simion Macarie, Macarie DM. Phacoemulsification in adult patients with post-uveitis complicated cataract. Romanian Journal of Ophthalmology [Internet]. 2018 Apr];62(2):135. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6117518/
15. Vivien Cherng Hui Y, Sanjay S, Benjamin Chong-Ming C. Anterior capsule tear after laser iridotomy complicating phacoemulsification. Saudi Journal of Ophthalmology [Internet]. 2011 Jul;25(3):309–11. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3729732/
16. Flores Márquez A, Urbinati F, Rocha-de-Lossada C, Moreno Gutiérrez JÁ, Munteanu M, Ferrara M, et al. Management of Suprachoroidal Hemorrhage during Phacoemulsification: A Comprehensive Review. Medicina [Internet]. 2023 Mar 15;59(3):583. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10058410/pdf/medicina-59-00583.pdf
17. Ren Y, Du S, Zheng D, Shi Y, Pan L, Yan H. Intraoperative intravitreal triamcinolone acetonide injection for prevention of postoperative inflammation and complications after phacoemulsification in patients with uveitic cataract. BMC Ophthalmology [Internet]. 2021 Jun 4;21(1). Available from: https://link.springer.com/article/10.1186/s12886-021-02017-y
18. Oudjani N, Renault D, Courrier E, Malek Y. Phacoemulsification And Zonular Weakness: Contribution Of The Capsular Tension Ring With A Thread. Clinical Ophthalmology. 2019 Dec;Volume 13:2301–4.
19. Day AC, Donachie PHJ, Sparrow JM, Johnston RL. United Kingdom National Ophthalmology Database Study of Cataract Surgery. Ophthalmology [Internet]. 2016 Aug ;123(8):1711–5. Available from: https://pubmed.ncbi.nlm.nih.gov/27342788/
20. Jena N, Saran S, Mishra A, Agarwal S, Lodha N, Lakhani HA. Visual Outcomes and Complication Profiles of Phacoemulsification in Diabetic Versus Non-diabetic Patients. Cureus [Internet]. 2026 Jan 19]; Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12914611/
21. Chan E, Mahroo OAR, Spalton DJ. Complications of cataract surgery. Clinical and Experimental Optometry [Internet]. 2010 Nov 1;93(6):379–89. Available from: https://pubmed.ncbi.nlm.nih.gov/20735786/
22. Wang. A Global View on Output and Outcomes of Cataract Surgery With National Indices of Socioeconomic Development. Investigative ophthalmology & visual science [Internet]. 2017; 58(9). Available from: https://pubmed.ncbi.nlm.nih.gov/28728174/
23. Keles A, Sen E, Altas FB, Elgin U. Risk factors for posterior capsule rupture in mature cataract surgery: A study of 1302 cases. Indian Journal of Ophthalmology [Internet]. 2022 Dec 30;71(1):113–8. Available from: https://pubmed.ncbi.nlm.nih.gov/36588219/
24. Kessel L, Flesner P, Andresen J, Erngaard D, Tendal B, Hjortdal J. Antibiotic prevention of postcataract endophthalmitis: a systematic review and meta‐analysis. Acta Ophthalmologica [Internet]. 2015 Mar 16;93(4):303–17. Available from: https://pubmed.ncbi.nlm.nih.gov/25779209/
25. Garcia AP, Liedtke FS. Phacoemulsification associated with loss of endothelial cells in cataract surgery: a systematic review of main surgical techniques. MedNEXT Journal of Medical and Health Sciences. 2023;4(2):e2023212. Available from: https://www.semanticscholar.org/paper/Phacoemulsification-associated-with-loss-of-cells-a-Garcia-Liedtke/900671549b41b8dbfdebe5ad9fe8d37948733801
26. Okoye GS, Bonabe D, Obasi CU, Munikrishna D, Osho F, Mutali M, Ogwumu K, Oke-Ifidon EO, Nathan IG, Enaholo ES, Suleman AI, Chukwuyem C, Enang AE, Oji RC, Ogechukwu VN, Chidera SP, Ogechukwu HC, Kaur K, Gurnani B. Visual outcomes and complications after phacoemulsification and small incision manual cataract surgery in two eye hospitals, Journal Français d'Ophtalmologie, Volume 48, Issue 1, 2025, 104353,ISSN 0181-5512, Available from: https://www.sciencedirect.com/science/article/pii/S0181551224002985
27. Koser E, Atik BK, Emul M, Ahmet S, Besek NK, Cubuk MO, Kirgiz A. Clinical features, management, and outcomes of posterior capsule rupture during phacoemulsification surgery. Arq Bras Oftalmol. 2025 Jul 21;88(5):e20240328. doi: 10.5935/0004-2749.2024-0328. PMID: 40699111; PMCID: PMC12997577. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12997577/
28. Narayan A, Evans JR, O'Brart D, Bunce C, Gore DM, Day AC. Laser‐assisted cataract surgery versus standard ultrasound phacoemulsification cataract surgery. Cochrane Database of Systematic Reviews 2023, Issue 6. Art. No.: CD010735. DOI: 10.1002/14651858.CD010735.pub3. Accessed 27 April 2026. Available from https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010735.pub3/full
29. Made Chindy Dwiyanti Marheni Putri, Wahyuni I, Utami DM, Farid ZM, Kloping NA. The safety and Efficacy of Phacoemulsification in Diabetic Versus Non-Diabetic Patients: A Systematic Review and Meta-Analysis: Doi: 10.36351/pjo.v41i2.1958. pak J Ophthalmol [Internet]. 2025 Mar. 30 [cited 2026 Apr. 27];41(2). Available from: https://pjo.org.pk/index.php/pjo/article/view/1958
30. Haji O, Gronczewska L, Green AS, et al. Phacoemulsification Versus Manual Small Incision Cataract Surgery: An Umbrella Review of Systematic Reviews. Cureus. 2025 Nov 13;17(11):e96753. DOI: 10.7759/cureus.96753. Available from: https://rheumatology.cureus.com/articles/432625-phacoemulsification-versus-manual-small-incision-cataract-surgery-an-umbrella-review-of-systematic-reviews
2. Welch Ruiz G, Cruz Blanco M, Escalona Tamayo M de J, Fundora Salgado V. Facoemulsificación en la cirugía de catarata. Revista Cubana de Medicina Militar [Internet]. 2017 Sep 1;46(3):244–55. Available from: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-65572017000300005
3. Álvarez-Rementería Fernández L. Complicaciones durante la facoemulsificación [Internet]. Available from: https://secoir.org/wp-content/uploads/2022/09/2016-Cap-21-Complicaciones-durante-la-facoemulsificacion.pdf
4. Mayor Orezime Atima, Ugbede Idakwo, Oyeronke Komolafe, Shimizu E, Nakayama Shintaro, Emmanuel Oluwadare Balogun, et al. Long‐Term Outcomes of Phacoemulsification Surgeries at ECWA Eye Hospital: A Prospective Clinical Cohort Study. Journal of Ophthalmology. 2024 Jan 1;2024(1).
5. Villanueva-Nájera MÁ, Herrero-Herrera S. Resultados visuales en pacientes operados de facoemulsificación con implante de lente intraocular libre de microvacuolas en el Hospital General de México. Revista Mexicana de Oftalmología. 2015 Oct;89(4):205–9.
6. Cicinelli MV, Buchan JC, Nicholson M, Varadaraj V, Khanna RC. Cataracts. The Lancet [Internet]. 2023 Feb;401(10374):377–89. Available from: https://pubmed.ncbi.nlm.nih.gov/36565712/
7. Qureshi MH, Steel DHW. Retinal detachment following cataract phacoemulsification—a review of the literature. Eye [Internet]. 2019 Oct 1;34(4):616–31. Available from: https://pubmed.ncbi.nlm.nih.gov/31576027/
8. Li A, He Q, Wei L, Chen Y, He S, Zhang Q, et al. Comparison of visual acuity between phacoemulsification and extracapsular cataract extraction: a systematic review and meta-analysis. Annals of Palliative Medicine. 2022 Feb;11(2):551–9.
9. Aguilar C, Ramos S, Eric MD, Puertas, H, Eneida C, Cárdenas Díaz, Taimi. Factores asociados a la hipertensión ocular después de una facoemulsificación no complicada. Revista Cubana de Oftalmología [Internet]. 2018 [cited 2026 Apr 21];31(2):1–11. Available from: http://scielo.sld.cu/scielo.php?pid=S0864-21762018000200006&script=sci_arttext
10. Siamak Zarei-Ghanavati, Hadi Y, Habibi A, Khorasani MA, Yoo SH. Cataract and Diabetes: a review of the literature. Journal of Cataract & Refractive Surgery [Internet]. 2024 Sep 9; Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11556822/
11. Bhagat PR, Prajapati KM. Manual small-incision cataract surgery and glaucoma – A dilemma of the duo. Indian Journal of Ophthalmology. 2022 Nov;70(11):3797–802.
12. Song X, Li L, Zhang X, Ma J. Comparing the efficacy and safety between femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery: systematic review and meta-analysis. Canadian journal of ophthalmology Journal canadien d’ophtalmologie [Internet]. 2025 Feb;60(1):e1–10. Available from: https://pubmed.ncbi.nlm.nih.gov/39043258/
13. Bhagat N, Nissirios N, Potdevin L, Chung J, Lama P, Zarbin MA, et al. Complications in resident-performed phacoemulsification cataract surgery at New Jersey Medical School. British Journal of Ophthalmology [Internet]. 2007 Oct 1;91(10):1315–7. Available from: https://bjo.bmj.com/content/91/10/1315.short?casa_token=2marpJZLjEUAAAAA:dR8BLczYqE9PVt4DPHZe9Y8AGo2lPS1zv2wbtJ0X9BX16gSuRGv5EFywpqtpwifvrOxOhJ6w49r9rZ1T
14. Sorin Simion Macarie, Macarie DM. Phacoemulsification in adult patients with post-uveitis complicated cataract. Romanian Journal of Ophthalmology [Internet]. 2018 Apr];62(2):135. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6117518/
15. Vivien Cherng Hui Y, Sanjay S, Benjamin Chong-Ming C. Anterior capsule tear after laser iridotomy complicating phacoemulsification. Saudi Journal of Ophthalmology [Internet]. 2011 Jul;25(3):309–11. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3729732/
16. Flores Márquez A, Urbinati F, Rocha-de-Lossada C, Moreno Gutiérrez JÁ, Munteanu M, Ferrara M, et al. Management of Suprachoroidal Hemorrhage during Phacoemulsification: A Comprehensive Review. Medicina [Internet]. 2023 Mar 15;59(3):583. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10058410/pdf/medicina-59-00583.pdf
17. Ren Y, Du S, Zheng D, Shi Y, Pan L, Yan H. Intraoperative intravitreal triamcinolone acetonide injection for prevention of postoperative inflammation and complications after phacoemulsification in patients with uveitic cataract. BMC Ophthalmology [Internet]. 2021 Jun 4;21(1). Available from: https://link.springer.com/article/10.1186/s12886-021-02017-y
18. Oudjani N, Renault D, Courrier E, Malek Y. Phacoemulsification And Zonular Weakness: Contribution Of The Capsular Tension Ring With A Thread. Clinical Ophthalmology. 2019 Dec;Volume 13:2301–4.
19. Day AC, Donachie PHJ, Sparrow JM, Johnston RL. United Kingdom National Ophthalmology Database Study of Cataract Surgery. Ophthalmology [Internet]. 2016 Aug ;123(8):1711–5. Available from: https://pubmed.ncbi.nlm.nih.gov/27342788/
20. Jena N, Saran S, Mishra A, Agarwal S, Lodha N, Lakhani HA. Visual Outcomes and Complication Profiles of Phacoemulsification in Diabetic Versus Non-diabetic Patients. Cureus [Internet]. 2026 Jan 19]; Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12914611/
21. Chan E, Mahroo OAR, Spalton DJ. Complications of cataract surgery. Clinical and Experimental Optometry [Internet]. 2010 Nov 1;93(6):379–89. Available from: https://pubmed.ncbi.nlm.nih.gov/20735786/
22. Wang. A Global View on Output and Outcomes of Cataract Surgery With National Indices of Socioeconomic Development. Investigative ophthalmology & visual science [Internet]. 2017; 58(9). Available from: https://pubmed.ncbi.nlm.nih.gov/28728174/
23. Keles A, Sen E, Altas FB, Elgin U. Risk factors for posterior capsule rupture in mature cataract surgery: A study of 1302 cases. Indian Journal of Ophthalmology [Internet]. 2022 Dec 30;71(1):113–8. Available from: https://pubmed.ncbi.nlm.nih.gov/36588219/
24. Kessel L, Flesner P, Andresen J, Erngaard D, Tendal B, Hjortdal J. Antibiotic prevention of postcataract endophthalmitis: a systematic review and meta‐analysis. Acta Ophthalmologica [Internet]. 2015 Mar 16;93(4):303–17. Available from: https://pubmed.ncbi.nlm.nih.gov/25779209/
25. Garcia AP, Liedtke FS. Phacoemulsification associated with loss of endothelial cells in cataract surgery: a systematic review of main surgical techniques. MedNEXT Journal of Medical and Health Sciences. 2023;4(2):e2023212. Available from: https://www.semanticscholar.org/paper/Phacoemulsification-associated-with-loss-of-cells-a-Garcia-Liedtke/900671549b41b8dbfdebe5ad9fe8d37948733801
26. Okoye GS, Bonabe D, Obasi CU, Munikrishna D, Osho F, Mutali M, Ogwumu K, Oke-Ifidon EO, Nathan IG, Enaholo ES, Suleman AI, Chukwuyem C, Enang AE, Oji RC, Ogechukwu VN, Chidera SP, Ogechukwu HC, Kaur K, Gurnani B. Visual outcomes and complications after phacoemulsification and small incision manual cataract surgery in two eye hospitals, Journal Français d'Ophtalmologie, Volume 48, Issue 1, 2025, 104353,ISSN 0181-5512, Available from: https://www.sciencedirect.com/science/article/pii/S0181551224002985
27. Koser E, Atik BK, Emul M, Ahmet S, Besek NK, Cubuk MO, Kirgiz A. Clinical features, management, and outcomes of posterior capsule rupture during phacoemulsification surgery. Arq Bras Oftalmol. 2025 Jul 21;88(5):e20240328. doi: 10.5935/0004-2749.2024-0328. PMID: 40699111; PMCID: PMC12997577. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12997577/
28. Narayan A, Evans JR, O'Brart D, Bunce C, Gore DM, Day AC. Laser‐assisted cataract surgery versus standard ultrasound phacoemulsification cataract surgery. Cochrane Database of Systematic Reviews 2023, Issue 6. Art. No.: CD010735. DOI: 10.1002/14651858.CD010735.pub3. Accessed 27 April 2026. Available from https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010735.pub3/full
29. Made Chindy Dwiyanti Marheni Putri, Wahyuni I, Utami DM, Farid ZM, Kloping NA. The safety and Efficacy of Phacoemulsification in Diabetic Versus Non-Diabetic Patients: A Systematic Review and Meta-Analysis: Doi: 10.36351/pjo.v41i2.1958. pak J Ophthalmol [Internet]. 2025 Mar. 30 [cited 2026 Apr. 27];41(2). Available from: https://pjo.org.pk/index.php/pjo/article/view/1958
30. Haji O, Gronczewska L, Green AS, et al. Phacoemulsification Versus Manual Small Incision Cataract Surgery: An Umbrella Review of Systematic Reviews. Cureus. 2025 Nov 13;17(11):e96753. DOI: 10.7759/cureus.96753. Available from: https://rheumatology.cureus.com/articles/432625-phacoemulsification-versus-manual-small-incision-cataract-surgery-an-umbrella-review-of-systematic-reviews
Publicado
2026-06-05
Cómo citar
Alcala Robles, M., Pérez Suárez , A., Roa Artigas , F., López Mena , A. M., Tinoco Mejía, S., Figueroa Aboytes, J. L., González de la Vega , A. B., Barrera Jiménez , R., Ortiz Guerra, D. F., & Franco Rojas , D. (2026). Resultados Visuales y Complicaciones de la Facoemulsificación en Cirugía de Catarata: Revisión Sistemática. Ciencia Latina Revista Científica Multidisciplinar, 10(3), 1293-1314. https://doi.org/10.37811/cl_rcm.v10i3.24101
Número
Sección
Ciencias Sociales y Humanas
Derechos de autor 2026 Mariana Alcala Robles, Aimeé Pérez Suárez , Fernando Roa Artigas , Alicia Margarita López Mena , Sofía Tinoco Mejía, Jorge Luis Figueroa Aboytes, Alejandra Bravo González de la Vega , Regina Barrera Jiménez , Daniela Fernanda Ortiz Guerra, Diego Franco Rojas
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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