Timing of posterior capsular rupture during cataract surgery
Akshay Narayan1, Yan Ning Neo2,3, David Lockington4
1Stoke Mandeville Hospital, Aylesbury, UK. akshay.r.narayan@gmail.com.
Eye (London, England)
|July 24, 2025
Summary
Posterior capsular rupture (PCR) during cataract surgery most often occurs during phacoemulsification. Anterior capsular (AC) tears can alter this timing and affect intraocular lens (IOL) placement.
Area of Science:
- Ophthalmology
- Surgical Complications
- Cataract Surgery Outcomes
Background:
- Posterior capsular rupture (PCR) is a known complication of cataract surgery.
- Understanding the timing and associated factors of PCR is crucial for improving surgical safety.
Purpose of the Study:
- To determine the specific stage of cataract surgery when PCR occurs.
- To investigate the association between PCR and anterior capsular (AC) tears.
- To analyze the impact of PCR and AC tears on intraocular lens (IOL) implantation.
Main Methods:
- Retrospective, observational cross-sectional study.
- Analysis of 1042 cataract surgeries complicated by PCR at Moorfields Eye Hospital (2014-2018).
- Primary outcome: stage of PCR occurrence; Secondary outcomes: AC tear incidence, intraoperative complications, IOL location.
Main Results:
- PCR occurred most frequently during phacoemulsification (60%), followed by irrigation-aspiration (24%).
- 15% of PCR cases were associated with an AC tear.
- Significant differences in PCR timing and IOL location were observed between eyes with intact anterior capsulorhexis and those with AC tears (p<0.01).
Conclusions:
- Phacoemulsification is the predominant stage for PCR during cataract surgery.
- The presence of AC tears may influence the timing of PCR and the choice of IOL implantation site.
- Surgeons must remain vigilant for AC tears, as they can modify PCR events and subsequent management.
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