Outcomes and Complications of Phacoemulsification Cataract Surgery Complicated by Anterior Capsule Tear
Ali Sharifi1 *, Amin Zand1 , Neda Hayati1
- Department of Ophthalmology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
Abstract: To report the outcomes and complications of phacoemulsification cataract surgery complicated by anterior capsule tear.
Methods: In this prospective study, the patients who underwent phacoemulsification cataract surgery complicated by anterior capsule tear were enrolled. Demographic, biometric, intraoperative, and postoperative data were documented. The main evaluated outcomes were stage of anterior tear identification, intraoperative capsule complication rates, placement and design of intraocular lens, visual outcome, surgically induced astigmatism (SIA), and incidence of postoperative complications.
Results: 21 eyes of 21 patients with anterior capsule tear during phacoemulsification cataract surgery were enrolled. Anterior capsule tears were identified during the phacoemulsification (11 eyes, 52.4%), capsulorhexis (9 eyes, 42.9%), and irrigation/aspiration (1 eye, 4.7%). In 8 (38.1%) eyes, tears extended to the posterior capsule, and lead to vitreous loss. Endocapsular fixation of a 1-piece acrylic intraocular lens (IOL) was achieved in 4 (19.0%) eyes. Four (19.0%) eyes required implantation of a 3-piece acrylic IOL in the ciliary sulcus. Postoperative best corrected visual acuity at month 12 was significantly improved compared to the baseline (P < 0.001). Overall, SIA at month 12 was not statistically significant (P = 0.098). In postoperative 12 months follow up, cystoid macular edema and retinal detachment were observed in 2 (9.5%) and 1 (4.7%) eyes, respectively.
Conclusion: Anterior capsule tear is not an important complication during cataract surgery, solely. But, extension of the tear to the posterior capsule and the subsequent complications can affect the surgical outcomes and predispose the eye for postoperative morbidities.
