Incidence of Posterior Capsular Rupture in Routine and Complex Cataract Surgeries at a Major Training Institution

Reports on posterior capsular rupture (PCR) incidence in the US from the past decade are limited, and impact of trainee presence versus responsibility is unclear. We retrospectively analyzed a database of surgical complications within all cataract surgeries from 2022 to 2024 at the Moran Eye Center. PCR rates were stratified by case complexity and presence and direct responsibility of trainees. Among 14,240 cataract surgeries, the PCR rate was 0.67% (95% CI: 0.54-0.81%). PCR occurred more frequently in complex (1.4%) versus routine (0.5%) cases (p<0.001). In cases with PCR, 68% had vitreous loss and 34% reported anterior vitrector use. With assisting trainees present, PCR rate was elevated at 0.94% versus 0.23% without (p<0.001). When residents assisted, they caused PCR twice as often as attending physicians: 0.80% > 0.40% (p=0.03). Overall, up-to-date PCR incidence from a large academic center is provided. Case complexity and both trainee presence and responsibility significantly increased risk.