Posterior capsule tears during extracapsular cataract surgery in India
G. Natchiar, A. L. Robin, A. R. Nalgirkar and R. Krishnadas
Aravind Eye Hospital, Madurai, India.
We determined the incidence in a developing nation of posterior capsule
rupture during planned extracapsular cataract surgery and insertion of a
posterior chamber intraocular lens. The results, in part, determine whether
this complication limits the widespread utility of this procedure in
developing nations. We retrospectively reviewed charts of all patients
undergoing planned extracapsular cataract surgery during a 6-month period;
all patients received surgery as inpatients at the Aravind Eye Hospital,
Madurai, India, and all were southern Indians. We tried to exclude most
patients with prior ocular diseases associated with loss of zonular or
posterior capsule integrity. One eye of all eligible patients was included.
Extra-capsular cataract surgery was performed using manual irrigation and
aspiration with the insertion of a posterior chamber intraocular lens. In
this study, we evaluated the ability to maintain an intact posterior
capsule with the insertion of a posterior chamber intraocular lens during
surgery. Of 898 eyes operated on, 15 (1.7%) developed rents in the
posterior capsule, and seven of these had vitreous in the anterior chamber.
Nine of the 15 rents were in eyes with either traumatic or hypermature
lenses. We conclude that even in a developing nation where many cataracts
are mature, hypermature, or traumatic, extracapsular cataract surgery with
the insertion of a posterior chamber intraocular lens is technically
feasible if surgeons are skilled and experienced.
