Managing Posterior Capsular Rupture During Phacoemulsification Using IOL as Scaffold
Narrative Responses:
Purpose
To demonstrate the results of posterior capsular rupture (PCR) management with nuclear segments in situ using IOL as scaffold.
Methods
After PCR is detected chamber was formed and Phaco probe was withdrawn. Using bimanual technique nuclear segment was maneuvered into the Anterior Chamber (AC). Three-piece foldable IOL was inserted into the eye lower haptic going into the sulcus and upper haptic into the anterior chamber. Vitrectomy was performed whenever required. Segments/pieces were emulsified on top of the IOL in AC using lower settings. Cortical matter/epinucleus was removed. If there was appropriate support IOL was maneuvered in the capsular bag otherwise into the sulcus.
Results
Using Foldable IOL as barrier to vitreous gives enough support for emulsification of segments in anterior chamber and keep vitreous away. Out of seven cases we have done we had hyphema, increased reaction, early rise in IOP, and corneal edema in one case, slightly decentered IOL in one case, CME in two cases. BCVA was 20/20 in five cases and20/30 in two cases.This technique gives very good results and there is no need to convert to ECCE and posterior vitrectomy was not required in any case.
Conclusion
PCR management using foldable IOL as scaffold is very good technique to manage PCR. It avoids further vitreous loss and need of conversions. It also decreases further complications intra operatively and postoperatively.