Multimodal Management Of Vitreous Traction And Cystoid Macular Edema Following Posterior Capsule Rupture – A Case Report

Posterior capsule rupture is among the most significant complications of cataract surgery and may lead to vitreous prolapse, elevated intraocular pressure (IOP), and cystoid macular edema (CME). These sequelae can significantly compromise visual outcomes. Early diagnosis and timely intervention are critical to prevent permanent visual impairment.

Mother Theresa Hospital, Tirane, Albania

A 65-year-old male presented for routine evaluation one month after cataract surgery performed at another institution. Best-corrected visual acuity was limited to counting fingers. Slit-lamp examination revealed a three-piece intraocular lens implanted in the sulcus with suspected posterior capsule rupture. Anterior vitreous strands were noted adherent to the iris and extending toward the corneal endothelium. IOP was elevated at 28 mmHg. Optical coherence tomography (OCT) demonstrated cystoid macular edema.

Nd:YAG laser vitreolysis was performed to release anterior vitreous traction. Subsequently, three intravitreal injections of aflibercept (8 mg) were administered for management of CME.

At three-month follow-up, visual acuity improved from counting fingers to 4/10, with significant reduction of macular edema on OCT. Combined laser vitreolysis and anti-VEGF therapy may represent an effective strategy for managing complications secondary to posterior capsule rupture.