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. 2022 Jul;70(7):2426-2431.
doi: 10.4103/ijo.IJO_2764_21.

Morphological variations influencing the outcomes in posterior polar cataract

P R Aswin  1 , Kandukuri Harika  1 , Madhu Shekhar  1 , R Sankarananthan  1 , Amish Shah  1 , P Lakshmanan  2 , Haripriya Aravind  3
Affiliations

Morphological variations influencing the outcomes in posterior polar cataract

P R Aswin et al. Indian J Ophthalmol. 2022 Jul.

Abstract

Purpose: To study the intraoperative complications and postoperative clinical outcomes in different types of posterior polar cataract (PPC) following phacoemulsification, based on morphological classification.

Methods: All consecutive patients with PPC who underwent phacoemulsification during the study period from 2016 to 2019 were included and sub-grouped based on the morphological characteristics according to Daljit Singh's classification. Intraoperative complications such as posterior capsular rupture (PCR), vitreous loss, nucleus drop, and Postoperative best-corrected visual acuity (BCVA) at day 1 and day 30 were documented.

Results: A total of 388 eyes of 380 patients were included. Eighty nine (22.9%) eyes belonged to type 1, 135 (34.8%) belonged to type 2, 8 (2.1%) belonged to type 3, and 156 (40.2%) belonged to type 4. Thirty-five (9.3%) eyes had intraoperative PCR, with vitreous loss in 21 (60%) eyes, and nucleus/cortex drop in 5 (1.3%) eyes. Six (75%) eyes of type 3, 14 (10.04%) eyes of type 2, 12 (17.7%) eyes of type 4, and 3 (3.4%) eyes of type 1 PPC had PCR. PCR occurred more during the emulsification of the nucleus (18 cases, 51.4%). A significant correlation was seen between intraoperative PCR and type of PPC with a higher incidence in type 3 (P < 0.001). BCVA was found to be significantly worse on day 1 among patients with PCR compared to those who did not and improved well by day 30.

Conclusion: PPC morphology is significantly co-related with the occurrence of PCR, emphasizing the need for careful grading of posterior polar cataracts in predicting the risk of intraoperative complications.

Keywords: Complications; Daljit Singh grading; morphological classification; phacoemulsification; posterior polar cataract.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Anterior segment slit-lamp photography showing Type 1 (a), Type 2 (b), Type 3 (c) and Type 4 (d) PPC as per Daljit Singh’s classification
See this image and copyright information in PMC

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