Effect and outcomes of posterior capsule rupture in a district general hospital setting

Abstract

Purpose: To assess how patients from a district general hospital population were affected on a short-term basis after posterior capsule (PC) rupture during phacoemulsification cataract surgery.

Setting: Department of Ophthalmology, Raigmore Hospital, Inverness, United Kingdom.

Methods: This retrospective audit encompassing a 2-year period evaluated the incidence of PC rupture and its outcomes. Details of the patients' age, preoperative and final postoperative best corrected visual acuity (BCVA), ocular comorbidity, surgeon grade, number and duration of follow-up reviews, and postoperative complications were collected.

Results: Over the 2-year period, the PC rupture rate was 1.7% (45 PC ruptures in 2727 phacoemulsification cataract procedures). Thirty-eight eyes (84.4%) achieved a final BCVA of 6/12 or better. In 39 eyes (86.7%), final BCVA improved compared with BCVA at presentation. Mean duration of follow-up was 11.7 weeks. The most common extra procedure was anterior vitrectomy (64.4%). The most common postoperative complication was raised intraocular pressure (IOP) (exceeding 30 mm Hg) on the first postoperative day (20.0%) despite additional acetazolamide as prophylaxis. None developed infective endophthalmitis. Apart from 1 retinal detachment (2.2%) at week 27, all complications resolved by 19 weeks. No patient required additional long-term medication at the final visit.

Conclusion: Posterior capsule rupture impacted on the patient in the short-term in terms of additional surgical procedures, additional topical and oral medications, and number and duration of follow-up reviews. Most patients recovered an acuity of 6/12 or better. However, it is important to be vigilant of postoperative complications, especially raised IOP on the first postoperative day.