Table 1.
Results of published articles in the management of posterior polar cataract.
| Author | Type of study | Year | Number of eyes | Mean follow up (months) | Preop VA | Post op VA | Mean age (years) | Rate of posterior capsule rupture | IOL placement | Anterior vitrectomy | Dropped nucleus | Comments | Technique | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Siatiri and Moghimi | Prospective | 2006 | 23 patients 38 eyes | 9.5 (2–20) | 20/76 | 20/25 | 33.5 (19–65) | None | In the bag | None | None | – | Leaving the plaque for later Yag | |||
| Haripriya et al. | Technique | 2006 | 8 eyes | – | – | – | 23–54 | 12.5% | In the bag if no complicated In the sulcus with optic capture if complicated |
None | None | Amblyopia 8 eyes (21%) Retinitis pigmentosa with macular degeneration 2 eyes (5.2%) Posterior capsule plaque left for later YAG in 7 eyes (18.4%) |
Bimanual microphaco | |||
| Schroeder | Retrospective | 2005 | 13 eyes | 48 | 20/125 | 20/34 | 4 (median) (0.1–12) | Intentionally done for all | In the bag except 2 newborns left aphakic | Intentionally done in all | None | Occlusion therapy preceded the surgery (2 weeks to 3 years) | Bimanual irrigation aspiration | |||
| Lee and Lee | Retrospective | 2003 | 31 patients 36 eyes | – | – | 94.4% 20/40 or better | – | 11.1% | Not mentioned | Bimanual vitrectomy | None | – | Lambda technique with dry aspiration | |||
| Hayashi et al. | Retrospective | 2003 | 28 eyes | Not mentioned | 20/133 | 20/22 | 49.6 ± 16.4 (23 to 74) | 7.1% | In the bag for small opacities (<4 mm) In the sulcus after PPL if >4 mm with soft nucleus Sclera sutured after ICCE if >4 mm with hard nucleus |
– | 1 eye with large polar opacity then PPV done but later developed RD | – | Phaco if opacity <4 mm and soft nucleus PPV, PPL if opacity >4 mm and soft nucleus ICCE and scleral fixated IOL if opacity >4 mm and hard nucleus |
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| Taskapili et al. | Retrospective | 2007 | 23 eyes | 11 cortical viscodissection | 35.4 ± 12.4 | 72% 20/80 or better | 100% 20/80 or better | 54.8 ± 14.5 (38–80) | 9.1% | Bag or sulcus | Done if complicated | None | Amblyopia 4 eyes (14.3%) Foveal dysfunction post RD 2 eyes (7.1%) Macular degeneration 1 eye (3.6%) 9 eyes (32.1%) had the plaque left for later YAG capsulotmy |
Viscodissection | ||
| 12 no cortical viscodissection | 34.3 ± 13.4 | 66.6% 20/80 or better | 100% 20/80 or better | 50.4 ± 7.4 (33–62) | 41.6% | No viscodissection | ||||||||||
| Ghosh and Kirkby (posterior approach) | Prospective | 2008 | 11 eyes 8 patients | 13 | 20/40 | 20/20 | 49.7% | Intentional for all | Sulcus | Posterior vitrectomy | – | – | 3 ports PPL, PPV | |||
| Vasavada and Singh | Prospective | 1999 | 25 eyes | 13.72 (7–11) | Not mentioned | 72% were 20/30 or better before YAG 96% had a final VA of 20/30 or better | 52 (17–75) | 36% | In the bag if no rupture In the sulcus if capsule ruptured (except one case in the bag) |
2 port vitrectomy | None | 1 ruptured capsule case developed ME 3 weeks post op 1 microcornea did not improve beyond 20/120 No IOP rise No retinal break |
Low parameters phaco | |||
| Osher et al. | Retrospective | 1990 | 31 eyes 22 patients | 7.2 (1 week to 32 months) | – | 96.7% 20/40 or better | 53 (22–81) | 26% | In the bag in 25 eyes In the sulcus in 6 eyes |
4 cases out of 8 complicated cases needed vitrectomy | None | 6 patients left with plaques 4 of which underwent later YAG ’2 eyes IOL decentration (1 reposited surgically) | Low parameters phaco | |||
| Nagappa et al. | Technique | 2011 | 17 eyes | – | – | 20/28 | 54.18 ± 10.54 | 6% | In the bag except 1 case in the sulcus | Done in 1 case | – | – | Modified epinucleus removal | |||
| Salahuddin | Prospective | 2010 | 28 eyes 22 patients | 8 (2–24) | 14.3% 20/40 or better | 85.7% 20/40 or better | 46 (25–71) | 7.1% | Al in the bag except 2 | None | 1 eye | Two patients left with plaque | Inverse horse-shoe technique | |||
| Kumar et al. | Retrospective | 2010 | 51 patients 58 eyes | 35 < 4 mm | 15.4 (12–40) | Not mentioned | 94.8% were 20/40 or better | 97.14% | 56.6 ± 2.4 | 15.51% | 5.71% | In the bag except 1 | – | None | Amblyopia 10.7% ARMD3.6% | Standard phacoemulsification |
| 23 > 4 mm | 91.3% | 30.43% | ||||||||||||||
| Das et al. | Retrospective | 2008 | 81 eyes 59 patients | 9 (2–70) | 22% 20/30 or better | 93.8% 20/30 or better | 46 (17–65) | 31% | 74% in the bag 26% in the sulcus | Not mentioned | 2 eyes | 2 eyes had YAG | Chip and flip for soft cataracts. Stop and chop for hard cataracts. | |||
| Vajpayee et al. | Interventional case series | 2008 | 8 eyes | Not mentioned | 20/140 | 20/26 | 43.75 ± 2.5 | 100% (pre-existing) | In the bag | None | None | 2 eyes PCO ’2 eyes CME, 1 eye amblyopia | Layer-by-layer phacoemulsification | |||
| Mistr et al. | Retrospective | 2008 | 30 eyes | More than 4 weeks | 12% 20/40 or better | 84% 20/40 or better | 6.36 ± 2.95 (0.82–15.96) | 89% intentionally 1 eye accidentally at IOL insertion | 96% in the bag | Not mentioned | None | 1 eye CME | Standard lens aspiration Pars plicata posterior vitectorhexis |
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