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Management of Posterior Capsule Rent: Various Case Scenarios

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Posterior Capsular Rent

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Abstract

Posterior capsule rupture (PCR) along with corneal endothelial decompensation constitutes one of the commonest complications of cataract surgery with vision-threatening consequences [1]. Vitreous loss as a consequence of PCR is a dreaded intraoperative complication of cataract surgery. If not managed appropriately, it can have disastrous consequences such as endothelial decompensation, retinal detachment, endophthalmitis, recurrent uveitis, intractable glaucoma, and severe visual disability including blindness. According to various studies, the incidence of PCR varies from 0.5 to 7.5 % [2, 3] and has shown a progressive decline with the evolution of surgical techniques and technology used in cataract surgery. Owing to the surgical learning curve, PCRs are more common among beginner surgeons [4]. Cataract surgery has seen tremendous evolution since Susruta described couching, more than 3000 years ago [5]. Extracapsular cataract extraction (ECCE), first performed by Jacques Daviel in Paris in 1747, dominated till the early 1900s. Intracapsular cataract extraction (ICCE) was introduced by Smith in 1880 [6]. The subsequent decades saw the development of the classic sutured large-incision extracapsular cataract extraction, phacoemulsification, and manual small-incision cataract extraction [7].

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References

  1. Trinavarat A, Neerucha V. Visual outcome after cataract surgery complicated by posterior capsule rupture. J Med Assoc Thai. 2012;95 Suppl 4:S30–5.

    PubMed  Google Scholar 

  2. Osher RH, Cionni RJ. The torn posterior capsule: its intraoperative behavior, surgical management, and long-term consequences. J Cataract Refract Surg. 1990;16(4):490–4.

    Article  CAS  PubMed  Google Scholar 

  3. Desai P, Minassian DC, Reidy A. National cataract surgery survey 1997–98: a report of the results of clinical outcomes. Br J Ophthalmol. 1999;83:1336–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Ti SE, Yang YN, Lang SS, Chee SP. A 5-year audit of cataract surgery outcomes after posterior capsule rupture and risk factors affecting visual acuity. Am J Ophthalmol. 2014;157(1):180–5.

    Article  PubMed  Google Scholar 

  5. Duke-Elder S. Sushruta Samhita-Uttar Tantra. In: Duke-Elder S, editor. System of ophthalmology, vol. II. London: Kimpton; 1969, Chap. 17, verses 57–70. p. 249.

    Google Scholar 

  6. Dobree JH, Sorsby A. Modern ophthalmology, vol 4. London: Butterworths; 1964, Chap. 12. p. 972-000.

    Google Scholar 

  7. Ascaso FJ, Huerva V. The history of cataract surgery, cataract surgery. 2013. In: Farhan Zaidi, editor. ISBN: 978-953-51-0975-4, InTech. doi:10.5772/19243. Available from: http://www.intechopen.com/books/cataract-surgery/the-history-of-cataract-surgery.

  8. Apple DJ. Sir Harold Ridley and his fight for sight: he changed the world so that we may better see it. Thorofare: SLACK Incorporated; 2006.

    Google Scholar 

  9. Gimbel HV, Neuhann T. Development, advantages, and methods of the continuous circular capsulorhexis technique. J Cataract Refract Surg. 1990;16(1):31–7.

    Article  CAS  PubMed  Google Scholar 

  10. Gimbel HV. Posterior capsule tears using phacoemulsification-causes, prevention and management. Eur J Implant Refract Surg. 1990;2:63–9.

    Article  Google Scholar 

  11. Stern WH. Anterior segment vitrectomy. Aust J Opthalmol. 1981;9:3–19.

    Article  CAS  Google Scholar 

  12. Maumenee AE. Synposium: postoperative cataract complication. 111. Epithelial inversion of the anterior chamber: retinal detachment: corneal edema: anterior chamber hemorrhages: changes in the macula. Trans Am Acad Ophthalmol Otolaryngol. 1957;61:51.

    CAS  PubMed  Google Scholar 

  13. Boyd BF, Maumene AE, McLean JM. Advances in cataract surgery: management of vitreous prolapse. Hghlts Ophthal. 1959;3:272.

    Google Scholar 

  14. Machemer R, Buettner H, Norton EWD, Parel J-M. Vitrectomy: a pars plana approach. Trans Am Acad Ophthalmol Otola ryngol. 1971;75:813–20. 9.

    CAS  Google Scholar 

  15. Peyman GA, Dodich NA. Experimental vitrectomy instrumentation and surgical techniques. Arch Ophthalmol. 1971;86:548.

    Article  CAS  PubMed  Google Scholar 

  16. Narendran N, et al. The cataract national dataset electronic multicentre audit of 55 567 operations: risk stratification for posterior capsule rupture and vitreous loss. Eye (Lond). 2008;23(1):31–7.

    Article  Google Scholar 

  17. Chang DF, Campbell JR. Intraoperative floppy iris syndrome associated with tamsulosin. J Cataract Refract Surg. 2005;31(4):664–73.

    Article  PubMed  Google Scholar 

  18. Blomquist PH, Rugwani RM. Visual outcomes after vitreous loss during cataract surgery performed by residents. J Cataract Refract Surg. 2002;28(5):847–52.

    Article  PubMed  Google Scholar 

  19. Yeoh R. The ‘pupil snap’ sign of posterior capsule rupture with hydrodissection in phacoemulsification. Br J Ophthalmol. 1996;80(5):486.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Fishkind WJ, editor. Complications in phacoemulsification: avoidance, recognition, and management. New York: Thieme; 2002.

    Google Scholar 

  21. Fine IH. Cortical cleaving hydrodissection. J Cataract Refract Surg. 1992;18(5):508–12.

    Article  CAS  PubMed  Google Scholar 

  22. Little B. Completing phaco following anterior capsular tear. Saudi J Ophthalmol. 2010;24(3):95–9.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Blomquist PH, Pluenneke AC. Decrease in complications during cataract surgery with the use of a silicone-tipped irrigation/aspiration instrument. J Cataract Refract Surg. 2005;31(6):1194–7.

    Article  PubMed  Google Scholar 

  24. Couch SM, Bakri SJ. Use of triamcinolone during vitrectomy surgery to visualize membranes and vitreous. Clin Ophthalmol. 2008;2(4):891–6.

    PubMed  PubMed Central  Google Scholar 

  25. Dada T, Sharma N, Vajpayee RB, Dada VK. Conversion from phacoemulsification to extracapsular cataract extraction: incidence, risk factors, and visual outcome. J Cataract Refract Surg. 1998;24(11):1521–4.

    Article  CAS  PubMed  Google Scholar 

  26. Worst JGF, Los LI. Cisternal anatomy of the vitreous. Amsterdam/New York: Kugler Publications; 1995.

    Google Scholar 

  27. Oetting T. http://cataractsurgeryforgreenhorns.blogspot.in/.

  28. LeBoyer RM, Werner L, Snyder ME, Mamalis N, Riemann CD, Augsberger JJ. Acute haptic-induced ciliary sulcus irritation associated with single-piece AcrySof intraocular lenses. J Cataract Refract Surg. 2005;31(7):1421–7.

    Article  PubMed  Google Scholar 

  29. Micheli T, Cheung LM, Sharma S, Assaad NN, Guzowski M, Francis IC, Norman J, Coroneo MT. Acute haptic-induced pigmentary glaucoma with an AcrySof intraocular lens. J Cataract Refract Surg. 2002;28(10):1869–72.

    Article  PubMed  Google Scholar 

  30. Wintle R, Austin M. Pigment dispersion with elevated intraocular pressure after AcrySof intraocular lens implantation in the ciliary sulcus. J Cataract Refract Surg. 2001;27(4):642–4.

    Article  CAS  PubMed  Google Scholar 

  31. Barry P, Behrens-Baumann W, Pleyer U, Seal D. ESCRS guidelines on prevention, investigation and management of post-operative endophtalmitis. Version 2. Santen. Eur Soc Cataract Refract Surg. 2007:1–37. http://www.escrs.org/vienna2011/programme/handouts/ic-100/ic-100_barry_handout.pdf.

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None of the authors have any financial interests in any company or product mentioned in the text.

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Authors and Affiliations

  1. Cataract and Refractive Surgery, Narayana Nethralaya, 121/C, Chord Road, Rajajinagar, Bangalore, 560010, India

    Sudeep Das MD, Mathew Kurian MD, Purnima Raman Srivatsa MD & Nikhil Negalur MD

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  1. Sudeep Das MD
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  2. Mathew Kurian MD
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  3. Purnima Raman Srivatsa MD
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  4. Nikhil Negalur MD
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Correspondence to Sudeep Das MD .

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Editors and Affiliations

  1. Chief Cataract and Glaucoma Service, Chakrabarti Eye Care Centre, Trivandrum, Kerala, India

    Arup Chakrabarti

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Das, S., Kurian, M., Srivatsa, P.R., Negalur, N. (2017). Management of Posterior Capsule Rent: Various Case Scenarios. In: Chakrabarti, A. (eds) Posterior Capsular Rent. Springer, New Delhi. https://doi.org/10.1007/978-81-322-3586-6_11

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  • DOI: https://doi.org/10.1007/978-81-322-3586-6_11

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  • Publisher Name: Springer, New Delhi

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