New Step Management of Posterior Capsule Rupture

Saturday, April 18, 2015: 4:12 PM
Room 5A (San Diego Convention Center)
Sergio Canabrava, MD
David F. Fagundes, MD
Luiz A. Sell, MD
Marcelo V. Siqueira, MD
Sebastião Rodrigo R. Almeida, MD

This new step has been proposed to evaluate an easier posterior capsular rupture management in cataract surgery. During this complication, after removing the vitreous, inject an air bubble in the posterior chamber to prevents vitreous in the anterior chamber and eye hypotonia.

Ten patients were included. 5 using the new step and 5 using the traditional capsular posterior rupture management. Normally the surgeon maintains the Phaco Tip in the anterior chamber and injects OVD to prevent vitreous when posterior rupture happens. But sometimes the surgeon needs to use a vitrector to remove vitreous. We proposed to inject air bubble in the posterior chamber to prevent vitreous in the anterior chamber and to support IOL in the sulcus after removing all cortex, nucleous and vitreous. With this step, hypotonic eyes can be prevented and produces a better support to implant the IOL in sulcus.

During the traditional management 2 patients were detected with an important hypotonia eye. In one patient, we could not implant the IOL because of this hypotonia. In the second patient we used OVD to form the posterior segment and to insert the IOL. The surgery went well but the patient developed glaucoma in postoperative. 3 patients did not develop any complications.  Using the new step, the IOL was implanted in 5 patients. The management was easier, because eye hypotonia did not happen and less vitreous in the anterior chamber. The 5 IOL were easier implanted because the air bubble supported the lens.

When happens a posterior capsular rupture, the injection of a bubble air is an easier way to management hypotonic eye and to implantation IOL in the sulcus.