Posterior Capsule Rupture During Cataract Surgery

The natural lens is inserted normally inside a bag which is called capsular bag. This bag has front( anterior )surface and back( posterior ) surface. The vitreous lies behind the back surface of the bag.

During cataract surgery, the eye doctor will form a hole in the front surface of the bag in order to remove the natural lens (the cataract) and inside this bag the intraocular lens will be implanted.

Sometimes the back surface of the bag can be ruptured accidentally and the vitreous will have access to the anterior chamber.

This can raise the incidence of retinal detachment because the vitreous is attached to the retina and when the vitreous moves forward to the anterior chamber, it will pull to retina with it anteriorly, leading to retinal detachment.

Sometimes,through this hole, pieces of cataract can be dropped to the back of the eye.

This complication can be treated by vitrectomy and removal of the cataract pieces that were dropped to the back of the eye and the Intraocular Lens can be implanted either in the bag, the sulcus(Between the front surface of the bag and the back surface of the Iris or in the anterior chamber.

Choosing between the Bag, the sulcus and the anterior chamber for lens Implantation will depend mainly on the size of the rupture. If the size is small, IOL can be implanted in the bag. If the rupture is large and it involve only the back surface of the back, the IOL can be implanted in the Sulcus.

Sometimes, the rupture is very large and it involves both the back surface of the bag and also the front surface of the bag and in this case the IOL should be implanted in the anterior chamber.

Anterior Chamber Intraocular Lens in patient who had Posterior Capsule Rupture during Cataract Surgery.

The location of the lens is infront of the iris.

Anew way of IOL implantation is scleral fixation of IOL, in which the IOL will be implanted in the posterior chamber and it will be fixed in this position by suturing the haptics of the IOL with the sclera.

Sometimes when the rupture is small and with special type of IOL, the implantation can occur inside the bag.

Sulcus is the space between the iris and the anterior capsule.

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