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Cataract surgery management in bilateral posterior polar cataract

Poster Details

First Author: A.Pantalon ROMANIA

Co Author(s):    C. Feraru                    

Abstract Details


Polar posterior cataract (PPC) has always represented a challenge for the cataract surgeon due to the high chances of posterior capsule defects.


"Sf. Spiridon" University Hospital, Ophthalmology Unit, Iasi, Romania "Gr.T.Popa" University of Medicine and Pharmacy, Iasi, Romania


We hereby present the case of a 49 years old male patient who declared progressive bilateral visual acuity decrease. Systemic examination revealed cardiac failure, high blood pressure and multiple somatic defects. Ophthalmological evaluation showed extremely decreased vision: light perception in OD and count fingers in OS, with normal IOPs (OD=14mmHg, OS=12mmHg). Biometric measurements proved no abnormality; calculated IOL power in OD was 22D and 23.5D in OS. Slit lamp examination showed a completely opacified lens in OD, with normal ultrasound aspect, whereas in OS we detected a central lens opaque plaque with radial extensions and normal fundoscopy.


The high suspicion for progressive bilateral PPC mandated careful surgical approach when cataract was extracted in OD. After complete lens removal no defect was noted; the central PC thinning associated with a mild form of fetal vascularization persistence and the aim of PC stress reducion pleaded for a sulcus multipiece PC-IOL placement with favorable postop outcome. At 8 weeks follow-up, VAOD was stabile (0.8,cc) and IOP=15mmHg. The OD intraoperatory finding clarified the previous clinical suspicion for bilateral PPC, grade 4 in OD and grade 3 in OS (Schroeder classification). A similar procedure was performed in OS with excelent functional recovery.


PPCs often arise at the end of a hyaloid artery remnant, which can result in different and asymmetric clinical aspects, as it was the case for our patient. Usually for any lens opacity>4mm, the chance of PC is very high, yet in our case after removal of a totally opacified lens no such complication was met. Bilateral progressive PPC are less amblyopic, as proven by the excellent functional postop results. Good theoretical knowledge with high surgical expertise are mandatory for obtaining the best outcomes in such patients.

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