Management of the posterior capsule following posterior chamber lens implantation.

A retrospective review of posterior capsule management in 595 consecutive unselected posterior chamber lens implants performed between 10/1/76 and 9/30/79 is presented. The incidence of secondary discission required increased from 0.6%, in cases with zero to six months follow-up, to 18.4%, in cases with 24 to 36 months follow-up, to 18.4%, in cases with 24 to 36 months follow-up. A plano-convex posterior chamber lens design which allows the convex surface of the implant to contact the posterior capsule reduced the incidence of posterior capsule opacification by providing a barrier to cortical cell migration. When secondary discission is needed behind a posterior chamber lens, it may be performed successfully using a pars plana approach. Our data suggest that the incidence of the major complications of this technique, i.e. cystoid macular edema and retinal detachment, may be reduced by delaying capsulotomy for 12 months after implant surgery.