Incidence of Posterior Capsular Rupture during Phaco-surgery and Clinical Characteristics of Posterior Capsular Rupture Cases. |
Cheol Kim, Jin Hak Lee |
1Department of Ophthalmology, Seoul National University College of Medicine, Korea. jjhlee@plaza.snu.ac.kr 2Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Korea. |
초음파유화 수술 중 발생한 후낭파열의 빈도와 임상양상 |
김철 ( Cheol Kim ) , 이진학 ( Jin Hak Lee ) |
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Abstract |
PURPOSE To analyze posterior capsular rupture (PCR) incidence according to the surgeon's experience and the change of surgical method and to investigate the clinical characteristics of posterior capsular rupture cases. METHODS: We reviewed all the phacoemulsification (PE) cases retrospectively from January 1995 to December 2000 and identified posterior capsular rupture cases. The PCR incidence was calculated according to the accumulated number of cases and the change of surgical method and we analyzed PCR cases - the sites, areas, post-operative complications, the methods of IOL insertion and prognostic implications. RESULTS: The PCR incidence decreased to 3.3% (annual) as accumulated cases increased. However, it increased after the change of incisional method from scleral tunnel to clear cornea and decreased again to 2.1% (annual). The most common PCR site was located centrally and there were more PCR's on the operator's left side than the right side and at the proximal site to operator than the distal site. Most PCR areas were less than 20% of total posterior capsule area (78.8% of cases). Various complications occurred including retinal detachment and endophthalmitis, but the common complications were hyphema, peaking of the pupil and glaucoma. The cases by the scleral fixation method had higher complication rates and poorer visual prognosis than those by the other methods(p<0.03). CONCLUSION: The PCR incidence decreases with surgeon's experiences but it increases with the change of operational procedures and then decreases again. Most PCR's are small and occur at the center or to the operator's left side. The PCR is related to increased postoperative complications. |
Key Words:
cataract;phaco-surgery;phacoemulsification;posterior capsule;rupture;tear |
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