Clinical Investigation into Posterior Capsule Rupture in Phacoemulsification Operations Performed by Surgery Trainees

This retrospective cohort study investigated the occurrence rate, correlative factors, and prognosis of posterior capsule rupture (PCR) in phacoemulsification operations conducted by surgery trainees. This study assessed the first 200 phacoemulsification surgeries performed by six surgery trainees between August 2016 and December 2018. Cases were divided into two groups depending on whether they fell within the first 100 surgeries performed by a trainee (first 100 cases group) or the last 100 surgeries (last 100 cases group). The following clinical data were analyzed: the occurrence rate of PCR, whether this complication arose in the phaco or irrigation/aspiration (IA) phase, the occurrence of vitreous loss, retinal detachment, and dropped nucleus, the site of intraocular lens (IOL) implantation, and postoperative visual acuity. Thirty-nine of the 1200 cases (3.25%) experienced PCR. The occurrence rates of PCR and vitreous loss were higher in the first 100 cases group than in the last 100 cases group (P=0.015 and P=0.017). PCR occurred more frequently in the phaco phase in the first 100 cases group and in the IA phase in the last 100 cases group (P=0.012). There was no difference between the two groups in terms of site of IOL implantation, the occurrence of retinal detachment or dropped nucleus, and postoperative visual acuity. With a supervising surgeon and the selection of suitable cases, the occurrence rate of PCR in phacoemulsification operations performed by surgery trainees could be controlled to the desired level. The phase in which PCR most frequently occurred and the likelihood of vitreous loss differed depending on the level of surgical experience of the trainees. It is a lengthy process for surgery trainees to reach the stage at which they can manage PCR and complex cataract surgery independently.

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Prophylactic Circumferential Retinal Cryopexy to Prevent Pseudophakic Retinal Detachment after Posterior Capsule Rupture during Phacoemulsification

Journal of Ophthalmology ◽

10.1155/2015/807389 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4

Author(s):

T. Bertelmann ◽

C. Heun ◽

C. Paul ◽

E. Bari-Kacik ◽

W. Sekundo ◽

...

Keyword(s):

Retinal Detachment ◽

Absolute Risk ◽

Absolute Risk Reduction ◽

Posterior Capsule ◽

Number Needed To Treat ◽

Vitreous Loss ◽

Vitreous Cortex ◽

Posterior Capsule Rupture ◽

Pseudophakic Retinal Detachment ◽

Capsule Rupture

Purpose. To evaluate whether prophylactic circumferential retinal cryopexy (CRC) can prevent pseudophakic retinal detachment (PRD) development after posterior capsule rupture (PCR) during phacoemulsification.Methods. Retrospective patient chart analysis of eyes experiencing a PCR during phacoemulsification. Comparison of PRD development between eyes receiving CRC (cryo+ group) or not (cryo− group).Results. Overall 106 patients were analyzed, thereof 61 (58%) in the cryo+ and 45 (42%) in the cryo− group. In both clusters a total of 10 PRDs (9.4%) occurred, thereof 3 (30%) in the cryo+ as well as 7 (70%) in the cryo− group(p=0.087), 79.8 ± 81.58 weeks after PCR. Relative/absolute risk reduction in CRC-treated eyes was calculated to be 68%/11%. Prophylactic CRC reduced PRD development 0.3-fold. Number needed to treat was estimated to be 9.4.Conclusion. Prophylactic CRC might be a useful treatment option in eyes with PCR to hamper PRD development in the further course. Further research is indicated to evaluate this beneficial effect between eyes with and without a rupture of the anterior vitreous cortex and accompanying vitreous loss in an expanding number of eyes.

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Risk stratification for posterior capsule rupture and vitreous loss during cataract surgery

Eye ◽

10.1038/eye.2009.121 ◽

2009 ◽

Vol 24 (2) ◽

pp. 389-390 ◽

Cited By ~ 1

Author(s):

S Goverdhan ◽

L Anderson ◽

A Lockwood ◽

J Kirwan

Keyword(s):

Risk Stratification ◽

Cataract Surgery ◽

Posterior Capsule ◽

Vitreous Loss ◽

Posterior Capsule Rupture ◽

Capsule Rupture

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Clinical outcomes of combined sutureless vitrectomy with triamcinolone stain to manage vitreous loss resulting from posterior capsule rupture during phacoemulsification

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2006.07.023 ◽

2006 ◽

Vol 32 (12) ◽

pp. 2054-2059 ◽

Cited By ~ 9

Author(s):

Cheng-Jong Chang ◽

Shang-Yi Chiang ◽

Ching-Long Chen ◽

Teng-Yi Wang

Keyword(s):

Clinical Outcomes ◽

Posterior Capsule ◽

Vitreous Loss ◽

Posterior Capsule Rupture ◽

Sutureless Vitrectomy ◽

Capsule Rupture

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An anomalous foveal OCT-sign after posterior capsule rupture in cataract surgery: Complicated cataract surgery maculopathy

European Journal of Ophthalmology ◽

10.1177/1120672120937661 ◽

2020 ◽

pp. 112067212093766

Author(s):

Pietro Maria Talli ◽

Emilio Pedrotti ◽

Riccardo Sacconi ◽

Cristina Monterosso ◽

Luigi Caretti

Keyword(s):

Cataract Surgery ◽

Visual Impairment ◽

Outer Segment ◽

Posterior Capsule ◽

Complicated Cataract ◽

Frequent Event ◽

Vitreous Loss ◽

Posterior Capsule Rupture ◽

Capsule Rupture ◽

Sd Oct

Purpose: To report a series of novel optical coherence tomography (SD-OCT) foveal abnormalities, that we called “T-sign,” that were noticed after a complicated cataract surgery with posterior capsule rupture and vitreous loss. Methods: Retrospective case series of persistent foveal changes that incurred after anteroposterior vitreo-foveal traction secondary to phacoemulsification in presence of posterior capsule rupture. Results: The study included three eyes of three patients that incurred in complicated cataract surgery and intraoperative vitreo-foveal traction. During 8-month follow-up period peculiar abnormalities in fundus examination and in OCT scans were reported in all cases. Conclusion: Phacoemulsification in presence of posterior capsule rupture could induce a vitreo-foveal strain that could be transmitted to the cone outer segment tips (COST line) and inner–outer segment (IS/OS) junction. This focal stress is liable for “T-sign,” a persistent SD-OCT abnormality that induce a visual impairment and a slight metamorphopsia in the fixation point. Summary statement All over the world, more than 9.5 million cataract surgeries are completed each year.1 During surgery, many intraoperative complications could occur, and capsule rupture with vitreous loss is a frequent event. Phacoemulsification in presence of a wide posterior capsule rupture and vitreo-macular adhesion could induce a typical modification of the foveal structure and a permanent visual impairment.

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