[Complications after rupture of the lens capsule with vitreous body prolapse during routine cataract operations]

Abstract

Purpose: To evaluate the rate of complications and visual outcome after vitreous loss due to an unintended rupture of the posterior lens capsule during routine cataract surgery.

Patients and methods: The study included 32 consecutive patients who underwent planned cataract surgery by extra-capsular extraction or phacoemulsification during which the posterior lens capsule ruptured and vitreous prolaps occurred. In all patients, the same surgeon was called to continue with the operation. After substantial transpapillary vitrectomy, a posterior chamber lens was implanted in all patients. The pseudophakos was transsclerally fixed in 12 patients. Mean follow-up time was 20.9 months (range, 1.5 to 71.6 months).

Results: The list of complications included cystoid macula edema in 2 patients (2/32 or 6.2%), persisting corneal endothelial decompensation in 1 patient (1/32 or 3.1%), and dislocation of the pseudophakos in one patient (1/32 or 3.1%). Rhegmatogenous retinal detachment did not occur. Compared with the preoperative status, visual acuity increased in 26 patients (26/32 or 81%). Visual acuity of equal or better than 20/30 was achieved in 15 eyes (15/32 or 47%). In 5 eyes (5/32 or 16%), visual acuity was equal to or better than 20/25.

Conclusions: In eyes with a ruptured posterior lens capsule during routine cataract surgery eventually requiring vitrectomy, frequencies of complications are relatively low, if all vitreous adherent to the edges of the lens capsule rupture is removed by substantial transpapillary vitrectomy, and if in doubt of a sufficient lens capsule support for the posterior chamber lens, the pseudophakos is fixed by transscleral sutures.