Objective: To analyze the incidence, features and related factors of posterior capsular rupture (PCR) in extracapsular cataract extraction, the main intraoperative complication impairing the procedure of intraocular lens (IOL) implantation.
Methods: The PCR including zonular break and vitreous loss was recorded according to the stage of operative procedure in 757 eyes with senile cataract (the average age was 67.3 +/- 8.3 years).
Results: There were 51 eyes (6.7%) with PCR and 42 eyes (5.5%) of them accompanied with vitreous loss. The PCR in 17 eyes (33.3%) occurred during manual expression of the nucleus, 25 eyes (49.0%) in the course of aspiration of the cortex, and 9 eyes in the subsequent manipulations. Except the unexpected damage to the posterior capsule, the main factors were: smaller incision for the nucleus expression, lens dislocation during capsulotomy, small pupil in the course of cortex aspiration, high pressure from the posterior chamber and traction on capsular bag when removing anterior part of the cortex.
Conclusion: Intraoperatively, the prevention of PCR and improvement of management ability are very important for the IOL I-stage implantation.