Abstract
Objective:To compare the incidence of postoperative endophthalmitis after eventful cataract surgery i.e. posterior capsular rupture, in patients managed with anterior vitrectomy and intra ocular lens implantation intraoperatively to patients managed with anterior vitrectomy and intraocular lens implantation two weeks after the posterior capsule rupture.Methods:This comparative study was conducted at Layton Rahamatullah Benevolent Trust, Free Base Eye Hospital Korangi, Karachi from February 2017 to December 2018. The study included two groups, group A had patients with intra ocular lens implanted after posterior capsule rupture intraoperatively, while Group B had patients with intra ocular lens implanted after two weeks of initial surgery. Incidence rate of post-operative endophthalmitis was compared between two groups, which happened within six weeks after intra ocular lens implantation surgery.Results:Total number of cataract surgeries that were performed during the study was 37,969. Incidence of postoperative endophthalmitis was 0.0019%. The study enrolled patients with complicated cataract surgeries that were 3508 (0.09%). Out of which incidence of post-operative endophthalmitis that occurred in group A was 0.007% and group B was 0.002%. (p value <0.05). The study also found that complicated extracapsular cataract extraction with intraocular lens implantation had more cases of endophthalmitis compared to phacoemulsification with intraocular lens.Conclusion:This study showed that management of posterior capsular rupture through anterior vitrectomy and secondary intraocular lens implantation after two weeks has less chances of postoperative endophthalmitis.
Highlights
Cataract extractions are the most commonly performed intraocular surgery in the field of ophthalmology.[1]
Within 24 months, 75 cases were reported with endophthalmitis
Thirty-four cases were enrolled in the study as they had Posterior Capsule Rupture (PCR) and presented within six weeks of cataract surgery
Summary
Cataract extractions are the most commonly performed intraocular surgery in the field of ophthalmology.[1] Use of newer machines have made cataract extraction easier to perform.[2] There are many types of cataract surgery, in which phacoemulsification is most commonly performed. Other types include Extracapsular Cataract Extraction (E.C.C.E), Intracapsular Cataract Extraction (I.C.C.E), and Small Incision Cataract Surgery (S.I.C.S). Pak J Med Sci May - June 2020 Vol 36 No 4 www.pjms.org.pk 689 is Posterior Capsule Rupture (PCR).[3] PCR is the breach in continuity of posterior surface of human lens capsule. This can occur in removing the lens, during Intraocular Lens (IOL) implant, and cortex aspiration. PCR can be managed intraoperatively or later on after two to three weeks with secondary IOL implant, under cover of topical and systemic antibiotic and anti-inflammatory
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