J Korean Ophthalmol Soc.  2003 Jun;44(6):1311-1316.

Analysis of Cause and Outcome of Posterior Capsular Rupture during Phacoemulsification in Cataract Surgery

Affiliations
  • 1Department of Ophthalmology, Kangnam St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Korea. mskim@catholic.ac.kr

Abstract

PURPOSE
This study is to evaluate the time, cause, management and consequences of the posterior capsule rupture during cataract extraction using phacoemulsification. METHODS: We retrospectively reviewed the medical records of 30 eyes of 30 patients who had undergone posterior capsule rupture during cataract operation with phacoemulsification from February 1997 to February 2000. RESULTS: The rupture occurred most frequently during the phacoemulsification (46.7%) and irrigation and aspiration procedure (36.7%). The capsule-ruptured patients' preoperative conditions were small pupil (30.0%), lack of cooperation (10.0%) and high vitreous pressure (6.7%). But no specific reason was found in half of the cases; probably surgeon's incomplete technique was the cause. We performed anterior vitrectomy in 66.7% of all cases. All cases were started as phacoemulsification, with 4 cases (13.3%) requiring conversion to extracapsular cataract extraction. Intraocular lenses were implanted in the sulcus (53.3%) and in the bag (33.3%). Final corrected visual acuity of 0.5 or better was achieved in 83.3% and 0.8 or better was in 63.3%. Final visual acuity of 0.1 or worse was occurred in 2 cases (6.7%) and the reasons were corneal edema due to endothelial cell damage and postoperative intraocular pressure elevation, respectively. CONCLUSIONS: When properly managed, a torn posterior capsule can result in an excellent visual outcome. Preoperative and intraoperative management such as more frequent administration of mydriatics, use of iris retractors and retrobulbar anesthesia are most important to prevent the posterior capsule rupture.

Keyword

Phacoemulsification; Posterior capsular rupture; Topical anesthesia

MeSH Terms

Anesthesia
Cataract Extraction
Cataract*
Corneal Edema
Endothelial Cells
Humans
Intraocular Pressure
Iris
Lenses, Intraocular
Medical Records
Miosis
Mydriatics
Phacoemulsification*
Retrospective Studies
Rupture*
Visual Acuity
Vitrectomy
Mydriatics
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