Arteficial monoblock lenses implantation following rupture of posterior capsule during phacoemulsification surgery

Abstract

Background/Aim. Phacoemulsification is a modern surgical technique for cataract operations. Through minimal corneal wound (2.2-2.7 mm) lens nucleus is emulsificated and arteficial lens is implanted in capsular bag. Complications during operations are possible, and can vary from minor to very serious one, with consecutive visual loss. One of possible complications is rupture of posterior lens capsule, which could happen in any stage of operation. The aim of this study was to evaluate results of monoblock arteficial lens implantation in sulcus on the remains of anterior capsule and capsulorhexis after posterior capsule rupture during phacoemulsification. Methods. This prospective, non-comparative study included 19 patients with rupture of posterior capsule as a result of cataract operation with phacoemulsification method. Average monitoring time was 14 months (1-18). We analysed best corrected visual acuity, intraocular pressure, fundus findings, and implanted lens position with wawelight allegro oculizer (Scheimpflug camera). Results. Preoperative visual acuity was from L+P+ to 0.5. On first postoperative day visual acuity 0.02-0.08 was noted in 8 patients, from 0.1-0.4 also in 8 patients and 0.5 and more in 3 patients. After 12 months from the operation 15 patients had visual acuity better than 0.5. Among early complications corneal edema was noted in 6 cases, anterior chamber reaction with or without fibrin reaction in 8 cases and rise of intraocular pressure in 3 cases. All complications were reversibile. Conclusion. Posterior capsule rupture/break is a serious complication of phacoemulsification, hardly to prevent. Regarding size of posterior rupture, foldable monoblock arteficial lens can be implanted into the sulcus on the remains of anterior capsule in most of the cases, keeping the advantages of small corneal incision: smaller astigmatism, better postoperative visual acuity, faster wound healing and earlier visual rehabilitation.