The aim of the study was to evaluate the results of
phacoemulsification in eyes with posterior polar
cataract and to assess the risk factors for posterior capsular
rupture during phaco surgery. This prospective study included 13 patients (14 eyes) undergoing
phacoemulsification surgery with
intraocular lens implantation. Intact posterior
capsule was present in 10 (71.5%) eyes, posterior capsular
rupture in 4 (28.5%) eyes, one of them with vitreal loss and requiring anterior
vitrectomy. Of the eyes with intact posterior
capsule, 5 (35%) had capsular plaque which was removed by gentle aspiration; in one case posterior
capsulorrhexis was performed to remove the plaque; and postoperative
capsule was clear in 4 (28.5%) eyes. In 3 eyes with capsular
rupture, there was soft nucleus and capsular opacification greater than 3 mm in diameter, and the patients were under 40 years old. One capsular
rupture occurred in dense
cataract. The incidence of posterior capsular
rupture in our study was 28.5%; other authors reported the incidence between 7.1% and 36%. Many different techniques have been described by other surgeons to avoid capsular
rupture; however, in our opinion, posterior capsular
rupture could not be avoided in some cases. In our study, the risk factors for capsular
rupture in posterior polar
cataract were soft nucleus with large capsular opacification and younger patient age. Our results of visual acuity after
phacoemulsification in posterior polar
cataracts are consistent with those reported by other authors: in 9 eyes, visual acuity was 0.8 or more (Snellen chart), and in 5 eyes there was no satisfactory improvement of visual acuity, probably due to
amblyopia because the majority of the
cataracts were unilateral. Accordingly,
phacoemulsification in posterior polar
cataracts, when done carefully, leads to good postoperative results and good visual improvement in most cases.