Iintraocular Lens As A Glide After Posterior Capsule Rupture

Posterior capsule rupture in the presence of nucleus fragments during phaco presents a serious cataract surgery complication. The purpose of the case report is to present a case handling this complication using intraocular lens as a glide in order to avoid dislocation of the nucleus remnants in the vitreous cavity. 

Department of Ophthalmology, General Hospital of Lamia, Lam;ia, Greece

Posterior caspule rupture occured in the middle of quadrants removal phase. It appeared as a sudden clear red reflex. Immediate discontinuation of phaco was followed by the use of dispersive ocular viscoelastic device (OVD) and careful removal of the phaco handpiece. Subsequently, the nucleus fragments were moved to the anterior chamber and a 3-piece IOL was inserted (haptics in the sulcus)  under the nucleus  fragments. Phaco was continued using the optic of the IOL as a barrier, to prevent any fragments dislocate in the vitreous cavity and vitreous prolapse anteriorly. Cortex was removed by irrigation-aspiration after optic capture in the capsulorrexis opening. By the end of the surgery the IOL optic was positioned in the capsulorrhexis opening. Postoperatively, the patient remained in medication (topical steroid and NSAID drops) for 8 weeks. Visual acuity was 10/10. 

Timely recognition of posterior capsule rupture and appropriate management may provide excellent postoperative outcomes and save the patient from further surgeries.