Pars plana surgical capsulotomy for posterior capsular opacification (PCO)

To evaluate the safety and efficacy of pars plana surgical posterior capsulotomy in pseudophakic adults.

This prospective interventional case series was conducted at Sindh Govt Lyari General Hospital Karachi and Al- Noor Eye Hospital Karachi from June 2006 to May 2008. Complete ophthalmic examination of anterior and posterior segment was performed including assessment of type of posterior capsular opacification, measurement of intraocular pressure. Visual acuity, measurement of intraocular pressure and any unwanted complications were analyzed.

Seventy six (43.18%) patients were operated on both eyes. Mean age was 62.01 +/- 13.02 years. There were 104 (59.1%) females and 72 (40.9%) males. Visual acuity at presentation was found to be 6/9 to 6/18 in 130 (59.1%)eyes, 6/18 to 6/60 in 81(36.8%) and below 6/60 in 9 (4.1%) eyes. A significant reduction in intraocular pressure (13.8, +/- 1.4, P = 0.000) was noted on second post operative day. Intraoperative complication included subconjuctival haemorrhage in 22 (10%) eyes, pin head haematoma at the entry site in 7 (3.2%) eyes, pea head haematoma at the entry site in 8 (3.6%) eyes, minor grade of vitreous haemorrhage in 9 (4.1%) cases. Insufficient capsular opening was noted in 8 (3.6%) eyes. Clinically evident macular oedema in 4 (1.8%) eyes. We found no case of endophthalmitis or retinal detachment.

Surgical posterior capsulotomy is a safe and effective procedure in experienced hands and could be adopted in place of YAG laser.