P237

Purpose: To evaluate the rate of secondary complications after rupture of the posterior lens capsule during routine cataract surgery.

Patients and Methods: The study included 40 consecutive patients (1989 - 1997) in whom the posterior lens capsule had ruptured and marked vitreous prolaps had occurred, and in whom the same surgeon was called to take over the operation, guarding the principle of substantial transpupillary vitrectomy. Pseudoexfoliation of the lens was present in 6 eyes. Mean follow-up time was 16.7 months.

Results: The list of complications includes cystoid macula edema in 3 patients (7.5%), persisting corneal endothelial decompensation in 2 patients (5.0%), and dislocation of the pseudophakos in one patients 2.5%). In two patients, a Nd-YAG-capsulotomy became necessary due to opacification of the posterrior lens capsule in the optical axis. Rhegmatogenous retinal detachment did not occur. Final visual acuity ranged between 1/25 and 1.0 (median: 0.5). Forty percent of the eyes achieved a vision of equal or better than 0.6 and 15% achieved a vision of equal or better than 0.8.

Conclusions: In eyes with a ruptured posterior lens capsule during routine cataract surgery, rate of secondary complications, such as rhegmatogenous retinal detachment, cystoid macula edema, secondary open-angle or angle-closure glaucoma, dislocation of the IOL, and corneal decompensation, is relatively low, if a substantial transpupillary vitrectomy is performed, and if, in doubt of a sufficient lens capsule support for the intraocular lens, the pseudophakos is sutured transsclerally.

Department of Ophthalmology and Eye Hospital, Friedrich-Alexander University, Schwabachanlage 6, D-91054 Erlangen