ESCRS - PP05.09 - Posterior Polar Cataracts, How Many Really Require Vitreoretinal Intervention?

Posterior Polar Cataracts, How Many Really Require Vitreoretinal Intervention?

Published 2025 - 43rd Congress of the ESCRS

Reference: PP05.09 | Type: Poster

Authors: Madyan Qureshi* 1 , Stephen Winder 1

1Ophthalmology,Royal Hallamshire Hospital,Sheffield,United Kingdom

Purpose

  • Posterior polar cataracts (PPC) are often referred to the vitreoretinal services as there is a higher risk of posterior capsule rupture (PCR), if the capsule is involved.  
  • Determining clinically which cases have an intact posterior capsule can sometimes be difficult.
  • A tertiary centres experience (Royal Hallamshire Hospital, Sheffield) using anterior segment optical coherence tomography (AS-OCT) in assessing which PPC are considered high risk for PCR. 

Setting

  • A tertiary centres experience (Royal Hallamshire Hospital, Sheffield) using anterior segment optical coherence tomography (AS-OCT) in assessing which PPC are considered high risk for PCR. 

Methods

  • Retrospective review of electronic patient records (Medisoft) for cases diagnosed as PPC and cases who had lens status AS-OCT performed.  From Jan 2022 to Aug 2023.
  • Of these how many had an AS-OCT scan to assess the integrity of the posterior capsule.
  • AS-OCT scans reviewed and compared to surgical outcomes, PC rupture or not.

Results

  • 7 cases
  • Had an AS-OCT to assess posterior capsule status and had cataract surgery
  • NOTE: 5 cases had Dx of PPC and had uneventful cataract Sxin that eye, but did not have an AS-OCT
  • 1 case
  • AS-OCT showed an interrupted or discontinuous PC 
  • Cataract surgery was undertaken by a vitreoretinal surgeon and PCR was encountered and managed. 

Conclusions

  • AS-OCT is a useful tool in helping to determine which PPC involve the posterior capsule and therefore would benefit from vitreoretinal intervention. 
  • Literature shows high NPV, so we can be confident that if a PC looksintact on AS-OCT, only a small number will lead to PCR, so can be managed by non vitreoretinal surgeon.