Prevention and management of posterior capsule rupture.

PURPOSE

To present the means and technique used in our Department for prevention and management of posterior capsule rupture during planned extracapsular cataract extraction.

METHODS

Prospective analysis of 550 extracapsular cataract operations from October 1993 to March 1994. Our technique (a slight modification of Blumenthal's technique) included a triplanar watertight small scleral incision, a relatively large continuous curvilinear capsulorhexis, or can-opener capsulotomy, nucleus hydrodissection and hydroexpression, use of an anterior chamber maintainer and residual cortex removal through a 10 o'clock side-port corneal incision.

RESULTS

Best corrected postoperative visual acuity ranged from 7-10/10 in 93.45% of our cases. Posterior capsule rupture with or without vitreous loss occurred in 1.63% and 2.72% of the cases, respectively. These rates are much lower than those, observed, when we used the sclerocorneal incision and nucleus extraction with external pressure.

CONCLUSIONS

The combination of a triplanar watertight small scleral incision. A relatively large continuous curvilinear capsulorhexis, an anterior chamber maintainer and residual cortex aspiration through the 10 o'clock side-port corneal incision greatly reduced the posterior capsule rupture rate.