Title : Outcomes and complications of anterior capsule tear following phacoemulsification cataract surgery
Abstract:
Background: We aimed to present the outcomes and complications following phacoemulsification cataract surgery complicated by anterior capsule tears.
Methods: This study prospectively included patients who had phacoemulsification cataract surgery with anterior capsule tears. The primary outcomes evaluated were the tear stage, intraoperative capsule complications, type and placement of intraocular lens (IOL), visual outcomes, surgically induced astigmatism (SIA), and occurrence of postoperative complications.
Results: We included 21 eyes of 21 patients who had anterior capsule tears following phacoemulsification cataract surgery. Anterior capsule tears were detected in 11 eyes (52.4%) during phacoemulsification, in 9 eyes (42.9%) during capsulorhexis, and in 1 eye (4.7%) during irrigation/aspiration. Tears extended to the posterior capsule in 8 instances (38.1%), leading to vitreous loss. Endocapsular fixation of a 1-piece acrylic intraocular lens (IOL) was successful in 4 eyes (19.0%), while 4 eyes (19.0%) needed a 3-piece acrylic IOL implanted in the ciliary sulcus. At 12 months post-surgery, the best-corrected visual acuity (BCVA) showed a substantial improvement compared to baseline (P < 0.001). However, changes in BCVA after 12 months were insignificant (P = 0.098). During the 12-month surgical follow-up, cystoid macular edema was seen in 2 eyes (9.5%) and retinal detachment in 1 eye (4.7%).
Conclusion: Anterior capsule tears can predispose individuals to further adversities if spread to the posterior capsule, particularly when the intraocular lens is positioned outside the capsular bag. This situation might result in a decreased improvement in best-corrected visual acuity (BCVA), greater chances of SIA, and increased likelihood of further postoperative treatments.
Keywords: Cataract surgery; phacoemulsification; anterior capsule tear; posterior capsule rupture; vitreous loss.
