Surgical Techniques In Posterior Polar Cataract

To report our clinical experience in performing cataract surgery in eyes with posterior polar cataract, and specifically using femtosecond laser-assisted cataract surgery (FLACS) and hydrodissection.  

Ein-Tal Eye Center, Tel Aviv, Israel

Medical records of consecutive10 eyes of 6 patients with clinical diagnosis of PPC, were retrospectively reviewed. All surgeries were done by using FLACS. In all cases careful hydrodissection was done to separate the lens material from the posterior capsule.

There were 3 men and 3 females, ages 39-73 years (average 52.5years), two of them were implanted with toric lenses. In all eyes hydrodissection was successfully performed and the lens material was separated from the lens capsule prior to phacoemulsification. The posterior capsule remained intact during nucleus removal in all cases.  In one eye the posterior capsule broke during cortical cleaning and the tear was converted to small posterior capsulorhexis (PCCC). PC-IOLs were implanted within the capsular bags and no postoperative complications were recorded during follow-up in all eyes.

Hydrodissection can be safely performed in eyes with posterior polar cataract with no evidence of a preexisting posterior capsule rent. Hydrodissection is more gentile to the capsule than any other surgical maneuver and allows clean and efficient separation of the lens material from the thinned posterior capsule. Femtosecond laser capsulotomy and lens fragmentation is effective and may further assist surgery in these complicated cases.