Posterior polar cataract: Minimizing risks

Comparing surgical outcomes of management of posterior polar cataract, a congenital cataract, which is difficult to manage surgically and has been associated with poor surgical outcomes.

46 eyes of 38 patients with posterior polar cataract underwent phacoemulsification and PCIOL implantation.

In a prospective analytical study, 46 eyes of 38 patients with posterior polar cataracts underwent surgery at a zonal hospital of the armed forces. The posterior polar cataract incidence was 1.23 per 1000 with confidence interval (CI) of 0.0012. Of the 46 eyes operated, 6 had a posterior capsular rupture (PCR) (13.04%). The PCR incidence in normal cataracts is reported at approx. 1.1%, whereas, various studies have reported incidence of 6-36% in posterior polar cataracts. 41 eyes achieved a visual acuity of 6/12 or better (89.13%) and 39 eyes of 6/9 or better (84.78%). 4 patients had amblyopia (8.6%), Two patients developed macular edema (4.34%). Mean follow-up was 7 months (range 3-11 months). There was no case of nucleus drop or retinal detachment.

Posterior polar cataracts are a surgical challenge. With controlled surgery, well defined techniques, a good surgical outcome can be achieved with reduced incidence of PCR.