Vajpayee R B, Sharma N, Dada T, Gupta V, Kumar A, Dada V K
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Surv Ophthalmol. 2001 May-Jun;45(6):473-88. doi: 10.1016/s0039-6257(01)00195-3.
Any breach in the continuity of the posterior capsule is defined as a posterior capsule tear. Posterior capsule tears can be preexisting (congenital or traumatic), spontaneous, or intrasurgical. Preexisting/congenital posterior capsule tears have been related to an intrauterine insult. Posterior capsule tears due to trauma may occur as a consequence of direct mechanical impact due to perforation or blunt injury. Depending on the duration of time between the posterior capsular trauma and the cataract surgery, these posterior capsule tears can have different features. Intrasurgical posterior capsule tears are the most common and can occur during any stage of cataract surgery. Also, they may be planned in the form of primary posterior capsulorhexis. The conventional management consists of prevention of mixture of cortical matter with vitreous, dry aspiration, and anterior vitrectomy, if required. In addition, during phacoemulsification low flow rate, high vacuum, and low ultrasound are advocated if a posterior capsule tear occurs. Dislocated nucleus or nuclear fragments require vitrectomy and the use of perfluorocarbon liquids. In the presence of a posterior capsule tear, the IOL can be placed in the sulcus, if the capsular rim is available, or in the bag, if the tear is small. Scleral fixated posterior chamber lenses and anterior chamber IOLs can be implanted when the posterior capsule tear is large.
后囊膜连续性的任何中断都被定义为后囊膜撕裂。后囊膜撕裂可以是先前存在的（先天性或外伤性）、自发性的或手术中发生的。先前存在的/先天性后囊膜撕裂与宫内损伤有关。外伤性后囊膜撕裂可能是由于穿孔或钝性损伤导致的直接机械撞击所致。根据后囊膜创伤与白内障手术之间的时间间隔，这些后囊膜撕裂可能具有不同的特征。手术中后囊膜撕裂最为常见，可发生在白内障手术的任何阶段。此外，它们也可能以原发性后囊膜撕开的形式进行。传统的处理方法包括防止皮质物质与玻璃体混合、干式抽吸以及必要时进行前部玻璃体切除术。此外，如果发生后囊膜撕裂，在超声乳化过程中提倡采用低流速、高真空和低能量超声。脱位的晶状体核或核碎片需要进行玻璃体切除术并使用全氟碳液体。如果存在后囊膜撕裂，当有囊膜边缘时，人工晶状体可植入睫状沟，如果撕裂较小，也可植入囊袋内。当后囊膜撕裂较大时，可植入巩膜固定的后房型人工晶状体和前房型人工晶状体。
