Abstract
Posterior polar cataracts (PPC) have always been a challenge for cataract surgeons due to their inherently higher propensity for posterior capsule rupture. Over the years, several technical modifications in cataract surgery have been suggested to enhance safety and reduce the percentage of posterior capsule rupture rates in these posterior polar cataracts. This retrospective study tries to present the role and complications of no hydro phacoemulsification technique in management of posterior polar cataract.
 Aim: To evaluate the role of prehydro phacoemulsification and partial depth phacoemulsification with hydrodelineation in posterior polar cataract (PPC).
 Method: Medical records of 100 patients with clinical diagnosis of PPC, who underwent pre hydro phacoemulsification and partial depth phacoemulsification with hydrodelineation, were retrospectively reviewed.
 Results: The incidence of posterior capsule rupture (PCR) was 8% (8/100): 4 cases occurred during epinucleus removal, 3 cases occurred during IOL implantation, and 1 occurred during OVD removal after the implantation of the intraocular lens into the bag. No nucleus piece or lens materials dropped into the vitreous during cataract surgery, and no obvious postoperative complications were found during follow-up. All patients had improved best-corrected visual acuity (BCVA) 1 month postoperatively.
 Conclusion: Pre hydro phacoemulsification and partial depth phacoemulsification with hydrodelineation help to reduce the incidence of PCR and achieve satisfactory postoperative outcomes.
Highlights
Posterior polar cataract (PPC) is a type of developmental cataract characterized by a white, well-defined, distinctive discoid opacity located on or in front of the central posterior capsule (PC) [1]
Partial depth phacoemulsification was done in the centre of nucleus before doing hydro procedure
We believe that the possibility of anterior chamber collapse might be lower with this approach than starting from the main incision, so this approach might be helpful for avoiding the rupture of a weak PC
Summary
Posterior polar cataract (PPC) is a type of developmental cataract characterized by a white, well-defined, distinctive discoid opacity located on or in front of the central posterior capsule (PC) [1]. PPC presents a special challenge to the phaco surgeon due to its high risk of posterior capsule rupture (PCR), vitreous loss, and even nucleus drop during cataract surgery, which can occur because of extreme weakness, pre-existing dehiscence or tight adherence of opacity in the PC [2]. PCR occurs most often during the removal of the epinucleus [5] or the posterior polar opacity [6] for PPC cases. The methods delay the removal of the posterior polar opacity in the epinuclear plate until complete emulsification of the whole nucleus, to minimize the risk for dropping nuclear fragments and losing vitreous [5,6,7,8].
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