Managing the broken capsule.

PURPOSE OF REVIEW

Posterior capsular rupture is a common complication of cataract extraction surgery. Prompt management of anterior and posterior capsular tears may prevent associated complications or need for subsequent procedural intervention.

RECENT FINDINGS

When tears develop in the anterior capsule, novel techniques allow predictable rescue of a capsulorhexis, preventing radial extension to the posterior capsule. Several case series now describe techniques and outcomes of posterior assisted levitation techniques for a dislocated nucleus. Triamcinolone staining of the vitreous improves visualization and removal of vitreous in the anterior segment following capsular rupture. Recently published studies further describe the increased risks of endophthalmitis and retinal detachment following capsular tears.

SUMMARY

Several techniques may prove beneficial in the intraoperative management of an anterior capsular tear, a dislocated nucleus, or vitreous loss.