Table 1. Summary of studies on the surgical management of posterior polar cataract with impending dehiscence.
| Author | Number of eyes | Technique recommended by author | Hydrodissection/ hydrodelineation | Mobilization of the epinucleus | PCR (%) | Visual acuity achieved | Other outcome |
|---|---|---|---|---|---|---|---|
| Osher R8 | 31a | Low power, low infusion, slow-motion phaco | Yes/no | Aspiraion | 26 (8/31 eyes) | 20/40 or better in 97% | Vitreous loss in 4/31 (13%); IOL decentred in 2/31 (6%); sulcus fixation in 6/31 eyes (19%) |
| Vasavada AR7 | 25 | Delineation | NO/yes | Aspirattion | 36 (9/25 eyes) | 20/20 in 20/25 eyes (80%) | Plaque in 8/25 eyes (32%); sulcus fixation in 8/25 eyes (32%) |
| Allen D14 | NA | Viscodissection between the capsule and the cortex in four quadrants | No/yes | Viscodissection+aspiration | NA | NA | NA |
| Fine IH15 | NA | Modified hydrodissection in multiple quadrants, avoid over pressurizing the anterior chamber or capsular bag with viscoelastic or irrigation fluid | Yes/yes | Viscodissection+aspiration | NA | NA | NA |
| Hayashi K9b | 28 | Delineation | No/yes | Aspiration | 7 (2/25 eyes) | 20/20 achieved in 21 eyes | RD in 2/28 eyes (7%); plaque in 9 eyes (32%); dropped nucleus in 1/25 eyes (4%)c |
| Lee MW16 | 36 | ‘Lambda' technique for nucleus removal | No/yes | Dry aspiration with a Simcoe Cannula | 11 (4/36 eyes) | 20/40 or better in 94.4% | NA |
| Vasavada AR10 | 25 | Inside–out delineation | No/no | Multiquadrant hydrodissection, aspiration | 8 (2/25 eyes) | NA | Dropped nucleus in 1 eye (4%) |
| Haripriya A17 | 8 | Bimanual microphacoemulsification | No/yes | Microphaco tips | 12.5 (1/8 eyes) | NA | Plaque in 4/8 eyes (50%) |
| Kumar S11 | 58 | No/yes | 15.5 (9/58 eyes) | NA | Sulcus-fixated IOL in 8/58 eyes (14%) | ||
| Saitiri H5 | 38 | ‘Hydrodissection-free phacoemulsification technique' | No/yes | 0 | 20/40 or better in 34/38 eyes (89.4%) | Plaque in 7/38 eyes (18.4%) | |
| Chee SP18 | NA | Hydrodelamination, manual dis-assembly at the ends of the trough with nagahara chopper | No/yes | Aspiration | NA | NA | NA |
| Das S12c | 81 | No/yes | Aspiration | 31 (25/81 eyes ) | ≥20/30 in 76/81 eyes (94%) | Nucleus drop in 2/81 eyes (3%); sulcus-fixated IOL in 21/81 (26%) | |
| Nagappa S19 | 17 | Phaco-aspiration for distal epinucleus and hydrodissection for sub-incisional epiucleus | No/yes | Phaco-aspiration | 6 (1/17 eyes) | 0.87±0.19 | Posterior capsule plaque in 11.8% (2/17) |
| Ghosh YK13 | 11 | Planned pars plana vitrectomy, lensectomy and posterior chamber sulcus-fixated IOL | Not applicabled | Not applicabled | Not applicabled | 20/20 in 100% | Accidental iridectomy in 1/11 (9%); transient choroidal folds in 1/11 (9%); posterior segment haemorrhage in 1/11 (9%); retinal detachment in 1/11 (9%) |
Abbreviation: NA, not available.
a
Two cases had undergone a planned extracapsular cataract extraction.
b
Of the total 28 eyes, 25 eyes had phacoemulsification, two eyes had pars plana lensectomy and one eye had intracapsular cataract extraction.
c
In all, 61/81 eyes underwent phacoemulsification, 17/81 eyes underwent ECCE, 3/81 eyes underwent manual SICS.
d
Surgical management of posterior polar cataract through the posterior approach.