COMPLICATED POSTERIOR CAPSULORHEXIS - ETIOLOGY, MANAGEMENT, AND OUTCOME

Background-A 1 year retrospective analysis of 650 patients, who underw ent a posterior capsulorhexis on their intact capsules, was performed to examine the incidence of complications, their aetiologies, and the outcome. Methods-Data were analysed on 32 patients with complicated ca psulorhexis for type of surgery, preoperative and postoperative factor s, and relative risk factors for vitreous issue. Results-There were si x patients with vitreous loss. The posterior capsulorhexis was uncontr olled in 14 cases and difficult to perform in 12 cases. Implantation i nto the capsular bag was possible in all cases. Systemic vascular haza rd and old age (over 80 years) were found to be statistically signific ant risk factors for vitreous loss (p=0.002 and p=0.03 respectively). The mean follow up was 13.5 months (range 4-25 months). One patient de veloped a retinal detachment and two had a transient clinical cystoid macular oedema. Visual acuity of greater than or equal to 20/40 was ob tained in 93% of the patients. Conclusion-Loss of control of the poste rior capsulorhexis has a low incidence but can lead to serious problem s during surgery. A good knowledge of the technique is necessary to co mplete the procedure with a posterior capsulorhexis of the optimum siz e without vitreous loss.