Phacoemulsification in posterior polar cataract: does size of lens opacity affect surgical outcome?

BACKGROUND: To study the effect of size of the posterior polar opacity on surgical and visual outcome of phacoemulsification in posterior polar cataract.

SETTING:   Post Graduate Institute of Medical Education and Research, Chandigarh, India.

METHODS: Consecutive patients with posterior polar cataract who underwent phacoemulsification were analysed for intraoperative complications and postoperative outcome. The continuous curvilinear capsulorhexis size was kept approximately 5.5 mm, and hydrodelineation was done instead of hydrodissection.

RESULTS: There were 58 eyes of 51 patients who underwent phacoemulsification for posterior polar cataract. The mean follow-up time was 15.4 months (range 12-40 months). Twenty-three eyes had size of polar opacities 4 mm or more in diameter whereas 35 eyes had less than 4 mm. Posterior capsule rupture occurred in nine eyes (15.51%). In eyes with polar opacities 4 mm or more, seven (30.43%) had posterior capsule rupture whereas in eyes with less than 4 mm size, only two (5.71%) had posterior capsule rupture. Capsular bag placement of intraocular lens (IOL) was achieved in 50 eyes and sulcus-sulcus in eight eyes. Three-piece hydrophobic acrylic IOL was implanted in 47 eyes and all polymethylmethacrylate IOL in 11 eyes. Postoperatively best-corrected visual acuity of 6/12 or better was achieved in 55 eyes (94.8%) and three eyes achieved 6/24 or less.

CONCLUSION: Phacoemulsification in eyes with larger size of polar opacity has significant risk of posterior capsule rupture.