Impact Of Secondary Surgery On Visual Recovery After Posterior Capsule Rupture: A Real-World Comparative Study

To evaluate the impact of secondary surgical intervention on visual recovery following posterior capsule rupture (PCR) in routine cataract practice.

Single-centre retrospective study conducted in a UK National Health Service hospital.

Retrospective review of 5,628 consecutive cataract surgeries over 2 years from 01/01/2023 to 31/12/2024. PCR occurred in 68 eyes (1.21%). Five cases were excluded due to incomplete follow-up, leaving 63 eyes for analysis. Eyes were divided into those requiring secondary surgery (return to theatre) and those managed without re-intervention. Primary outcome was change in visual acuity (ΔlogMAR). Secondary outcomes included incidence of re-intervention, timing, intraoperative stage of PCR, and final intraocular lens (IOL) position.

Re-intervention was required in 20/63 eyes (31.7%). Median time to re-intervention was 22 days. PCR during nucleus/segment removal accounted for the majority of re-interventions (13/20). Final IOL position was sulcus in 45 eyes, bag in 7 and ACIOL in 10. Median visual acuity improvement was comparable between re-intervention and non–re-intervention groups (ΔlogMAR –0.20 vs –0.20).

In this real-world series, nearly one-third of PCR cases required secondary surgery. However, visual recovery was comparable between eyes undergoing re-intervention and those managed conservatively. These findings suggest that appropriate surgical management can preserve visual outcomes despite increased procedural burden.