Phacoemulsification in eyes with posterior polar cataract

J Cataract Refract Surg. 1999 Feb;25(2):238-45. doi: 10.1016/s0886-3350(99)80133-3.


Purpose: To evaluate the results of phacoemulsification in eyes with posterior polar developmental cataract and to appraise the strategy for surgical management.

Setting: Iladevi Cataract & IOL Research Centre, Raghudeep Eye Clinic, Ahmedabad, India.

Method: This prospective study comprised 25 consecutive patients. All surgeries were performed by 1 surgeon. Endophacoemulsification was carried out after hydrodelineation. Hydrodissection or rotation was not attempted. A 2-port vitrectomy was performed when necessary.

Results: Mean follow-up was 13.72 months (range 7 to 22 months). Nine patients (36%) developed posterior capsule rupture and 8 (32%) revealed plaques. An intraocular lens (IOL) was implanted in all 25 eyes. In 8 of 9 cases with rupture, the haptics were placed in the sulcus; in 1 case, the IOL was placed in the bag. One patient in the capsular rupture group developed macular edema 3 weeks postoperatively that responded to conservative treatment. Among 25 patients, 18 had a visual acuity of 20/20 to 20/30 and 6, 20/80 to 20/120. These 6 patients had residual posterior capsule plaque. All except 2 patients with plaque required a neodymium:YAG capsulotomy. In these patients, visual acuity improved to 20/30. In 1 patient, with microcornea, acuity did not improve to beyond 20/120.

Conclusion: This study confirms the predisposition to posterior capsule rupture in eyes with posterior polar cataracts. Careful surgical planning produces satisfactory technical and visual outcomes.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cataract / complications*
  • Cataract / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Laser Therapy
  • Lens Capsule, Crystalline / injuries
  • Lens Capsule, Crystalline / pathology
  • Lens Capsule, Crystalline / surgery
  • Lens Implantation, Intraocular
  • Male
  • Middle Aged
  • Phacoemulsification* / adverse effects
  • Phacoemulsification* / methods
  • Prospective Studies
  • Rupture / etiology
  • Treatment Outcome
  • Visual Acuity
  • Vitrectomy