[Surgical aspiration of secondary cataract. Success quotas and complications]

Cataracta secundaria ("Elschnig pearls") following extracapsular cataract extraction with IOL implantation can be treated by Neodymium-YAG laser capsulotomy or by surgical peeling. The major benefit of the peeling technique is the preservation of an intact posterior capsule. We retrospectively reviewed the peeling procedures (n = 224, mean age: 67 years) performed in our hospital from 1987 to 1990. The results were as follows: (1) In almost all cases (214/224) visual acuity was improved by the operation (mean improvement 0.16-->0.54); (2) major complications were: rupture of the posterior capsule in 9% (20 eyes), mostly (11 cases = 5%) associated with vitreous prolapse; retinal detachment in 1% (2 cases, one with, one without preceding rupture of the posterior capsule); persistnt corneal edema caused by endothelial decompensation in 1 case; (3) recurrence of cataracta secundaria after the first peeling was observed in 26%. Surgical peeling of cataracta secundaria improves visual acuity to about the same extent as Neodymium-YAG laser capsulotomy. It is not without risk, however, and complications occur, including retinal detachment. The possibility that a secondary cataract can reform must be taken into account.