An in depth discussion of posterior capsule rupture in cataract surgery.
October 13, 2022
In experienced hands, PCR is an infrequent occurrence during cataract surgery. Early on in our careers, PCR rates are generally higher, but with experience and refinement of technique, rates generally decrease. Despite this, PCR is one of the most common complications of cataract surgery. Certainly, it is more common in complex cases, such as trauma, pseudoexfoliation, previous vitrectomy, and intraoperative floppy iris syndrome , among others.
It is no surprise that the authors reported that visual and refractive outcomes were worse in patients with PCR. Additionally, those with PCR had more complications such as corneal edema,, increased intraocular pressure, and cystoid macular edema. They report a higher incidence of coexisting eye disease in 50.2% of PCR cases vs 23.4% of non-PCR cases. Despite the PCR, the majority of these patients had an improvement in vision compared with their presurgical state.
We all have cases of unexpected PCR. In persons with complicated eyes, the rate can be higher. I make it a point to take extra time to explain the increased risk for PCR in at-risk patients. Luckily, even in those with complex eyes, the incidence is low. Unfortunately, owing to the nature of the registry, the study only reported short-term outcomes of PCR. It would certainly be interesting to see how these patients fared over the long term.
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