Surgical suction in cataract extraction. Postoperative follow-up in 219 cases over 16 years of age

Abstract

Nd-YAG posterior capsulotomy in treatment of secondary cataract has the main disadvantage of increasing the risk for pseudophakic retinal detachment by destroying the posterior lens capsule. This is of great interest in high myopic eyes with an increased risk for pseudophakic retinal detachment. In 219 cases of secondary cataract in our clinic a surgical posterior capsule polishing has been performed and this group was followed up over 6 years looking for intra- and postoperative complications. The examined group included 209 myopic eyes with a bulbus length > 25 mm and 10 eyes with traumatic cataract; 24 eyes of this group had been primarily operated without a lens. The secondary cataract surgery was performed between 1990 and 1995, and the average follow-up period was 42 months. The intra- and postoperative complications were revealed retrospectively by examination of the patients in our clinic or by interviewing the patients' private doctors. The patients achieved a mean improvement in vision of 4 lines. In 9 cases intraoperative capsule rupture occurred (4%). In 35 of the operated eyes one or more relapses occurred during the follow-up period that made another polishing necessary (16%), and in 5 cases YAG capsulotomy was eventually performed (2%). Pseudophakic retinal detachment occurred in none of the cases. Surgical posterior capsule polishing is a low-risk procedure for treatment of regenerative secondary cataract. It is indicated especially in myopic eyes in order to reduce the risk of pseudophakic retinal detachment by conserving the posterior lens capsule.