Posters

Risk factors of posterior capsular rupture and visual outcome

Poster Details

First Author: B. Choy HONG KONG

Co Author(s):                        

Abstract Details

Purpose:

Posterior capsular rupture (PCR) is associated with many secondary complications which in turn affect visual outcome. We described the risk factors associated with PCR and its visual outcome, and to compare with existing literature.

Setting:

A single hospital in Hong Kong

Methods:

Medical record of the 2704 patients who received cataract surgery from May 2011 to March 2012 were reviewed. There was a total of 24 PCR (0.89%). The pre-operative (ocular and systemic) and intra-operative risk factors, surgical details, pre-operative and poste-operative visual acuity and secondary complications were studied. Patients with poor visual outcome were analysed.

Results:

24 eyes in 24 patients were included. 20 patients had phacoemulsification alone and 4 received phacoemulsifiation converted to extra-capsular cataract extraction. Most (50%) of the PCR happened during the chopping stage and in 62.5% of the patients, there was loss of vitreous. The mean time of surgery was 47 +/- 19 minutes. The majority of PCR occurred in grade 1 nuclear sclerosis cataract (41.7%) and the surgeries were performed by trainers (62.5%). 62.5% of the PCR occurred in cases which were graded as easy pre-operatively. In only 2 cases, visual acuity in the last visit was worse than pre-operatively.

Conclusions:

In contrary to common belief, PCR occurred more commonly in easy cases with no identifiable risk factors, and the surgeries were performed by trainers instead of residents. Possibly in cases where the cataract was graded as difficult pre-operatively, or when the surgeries were performed by trainees, the surgeons would be extra cautious during the surgery, and the PCR rate would be low. The vast majority (91.7%) of patient had improvement in vision post-operatively despite the presence of secondary complications in 37.5% of patients. When PCR is managed well, the visual outcome is unaffected in the majority of cases.

Financial Disclosure:

NONE