PurposeTo determine and quantify the risk factors for disruption of lens capsule integrity during phacoemulsification.MethodsThe medical records of the patients who had undergone phacoemulsification cataract surgery and had a complication associated with lens capsule were reviewed. Consecutive cases were also reviewed in reverse chronological order as a control group. The exclusion criteria were pediatric cataracts, traumatic cataracts and lens dislocation. As a result, 403 uncomplicated and 83 complicated eyes were analyzed. The differences between the complication group and the group without complications regarding the risk factors were shown by employing the Chi-square test and Fischer's exact test. The variables having the level of significance (p<0.25) after the Chi-square test and Fischer's exact test were enrolled into the multiple stepwise logistic regression analysis.ResultsAge (60-69/80) (p=0.017), male gender (p=0.006), pupil size 3mm (p=<0.001), mature-brunescent cataract (p=<0.001), anterior chamber depth <2.5mm (p=0.001), posterior polar cataract (p=0.006), diabetic retinopathy(p=<0.001), coronary artery disease (p=0.098) and surgeon factor (junior resident/senior resident, p=0.015; senior resident/specialist in ophthalmology, p=0.026; junior resident/specialist in ophthalmology, p=0.020) were among the factors significantly related to a capsule complication. An Excel program has been developed according to these results to predict the probability of capsule complication.ConclusionsHigher-risk cases can be predicted preoperatively, thus allowing surgeons to take appropriate precautions, better informing the patient and better selecting the cases especially for trainee surgeons.