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C. Rohart, F. Fajnkuchen, S. Buffet, M. Lé, G. Chaine; Visual Outcome and Complications After Posterior Capsule Rupture During Phacoemulsification Surgery. Invest. Ophthalmol. Vis. Sci. 2008;49(13):380.
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To determine the visual outcome and incidence of complications after posterior capsule rupture during phacoemulsification surgery.
The clinical charts of all patients who had posterior capsule rupture during phacoemulsification surgery over a 2-year period were retrospectively studied. Data included patient’s age, preoperative and final postoperative best corrected visual acuity (BCVA), preexisting ocular morbidity, surgeon grade, number and duration of follow-up reviews, postoperative complications (ocular hypertony, macular edema, retinal detachment, endophtalmitis), the occurrence of anterior vitrectomy and additional surgical or laser procedures were collected. Risk factors predisposing to intraoperative complication (pseudoexfoliation, pupillary dilatation, cataract intensity) were studied. We had calculated for each patient the Muhtaseb’s scoring.
Posterior capsule rupture occurred in 29 (2.5%) of 1148 consecutive eyes had phacoemulsification. Mean duration of follow-up was 4.3 ± 4.2 months. Twenty-one eyes (72.4 %) achieved a final best corrected visual acuity of 6/12 or better. In twenty-two eyes (75.8%), final BCVA improved compared with BCVA before surgery. Twenty eyes (69%) had vitreous loss and required anterior vitrectomy. The mean number of extra follow-up reviews was 5.2 ± 2.6. Additional surgical procedure was performed in 6 eyes (20.7%). The most common postoperative complication was raised intraocular pressure required additional topical and/or oral medications (34.5 %, 10 eyes). There was at least one risk factor predisposing to intraoperative complication in 18 eyes (62 %). No patient developed a retinal detachment, endophtalmitis or cystoid macular edema.
Most eyes with posterior capsule rupture achieved a good final postoperative best corrected visual acuity. Posterior capsule rupture impacted on the patient in terms of additional surgical procedures, additional topical and oral medications, and number and duration of follow-up reviews. It is important to monitor the patient and be vigilant of postoperative complications, especially raised intraocular pressure on the first operative day.
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