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Posterior polar cataract (PPC) management with new innovations

Poster Details

First Author: S.Chaudhary INDIA

Co Author(s):    R. Chaudhary   S. Jindal                 

Abstract Details


We introduced three changes in the management protocol of PPC for better control during surgery with resultant less chances of Posterior Capsular Rent (PCR)


Eye7 group of eye hospitals, New Delhi, India


Visco-dissection: Once the nucleus is removed after hydrodelineation, the epinuclear girdle sticking to the cortex is separated from the fornix of the bag using multiple point visco-dissection, extending the separation to 1.5 mm short of the PPC area. Low Intra Ocular Pressure (IOP): The surgery is done at an IOP of 30 mmhg with Active Fluidics. Anterior Chamber Maintainer (ACM): This is attached to a bottle height of 30 cm maintaining a stable chamber with a minimum IOP of 21 mmhg at all times, even while moving instruments in and out of the eye.


40 cases of PPC were performed. PCR was encountered in only two cases (5%). Visco-dissection results in gentle epinuclear girdle separation from the capsule without stress on the Posterior Capsule (PC). Low IOP Phaco with Active fluidics does not allow the IOP to cross 30 mmhg so less stress on the PC. ACM does not allow the IOP to fall below 21mmhg and keeps the Anterior Chamber (AC) stable, PC and vitreous at bay, eliminating the need of filling AC with visco every time the irrigator is pulled out of the eye.


Our two year old series has a PCR rate of 15%. Recent literature also mentions a PCR rate of 7.1% to 16.4%. Bringing the incidence to 5 % is a step forward. Without a hydro-dissection, removing the epinuclear girdle with an Irrigation Aspiration cannula poses a challenge, is time consuming and many a times the resultant manipulations or dialling the epinuclear girdle results in a PCR. Active fluidics and ACM improve the performance further

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