The Clinical Analysis Of Posterior Capsular Rupture With Cataract Extracted By Phacoemulsification

Phacoemulsification is a momentous technological progress of the clinical ophthalmology.Because of its merit,such as slight tissue damage,fast wound healing, slight postoperative astigmatism and the volant stabile visual rehabilitation, phacoemulsification is liken to the mass of the patients.As phacoemulsification is a subtle and complicate operation,it need a operator of the affluent operation skills and experiences.There are many unavoidable operational complications in phacoemulsification,and posterior capsular rupture is the superior and the most frequent operational complication.The supporting action of posterior capsular for intraocular lens partly or all loses because of posterior capsular rupture.It leads to harmful effects for the next operation,the implantation of intraocular lens and the visual rehabilitation of the patient etc.If the treatments are not correct and timely,the operational effects and the postoperative visual rehabilitations will be impacted.Objective: We managed to find the causes, the managements,the postoperative influences and the precaution principles of posterior capsular rupture in phacoemulsification.Methods: To statistically analysis 42 eyes which posterior capsular had ruptured during phacoemulsification in 312 eyes,and all of them were operated in the Third clinical hospital of Jilin University from January,2004 to December,2006.Results:1.According to the different etiological factors,we divided the cataract patients into the group age-related cataract and the group complicated cataract. The incidence rate of posterior capsular rupture in the group age-related cataract was 13.33%,and that in group complicated cataract was 13.79%. There was no significant difference between two groups statistically(P>0.05).2.According to the age,we divided cataract patients into groups. The incidence rate of posterior capsular rupture in groups of age less than 60, age from 60 to 70,age 70 to 80 and age older than 80 was 0, 11.76%,14.29% and 16.48% respectively. There was significant difference in four groups statistically(P<0.01).The datas of the above illustrarted that there was significant dependablity between posterior capsular rupture and age. The incidence rate of posterior capsular rupture reased with age increasing.3.According to the time of operation,we divided cataract patients into three groups. The incidence rate of posterior capsular rupture in groups of 2004, 2005, 2006 was 28.79%, 13.73% and 6.25% respectively. There was significant difference in the different time of operation groups statistically(P<0.01). This illustrated that the incidence rate of posterior capsular rupture was decreased progressively with the evolvement of phacoemulsification,the elevation of surgical technic and the accumulation of operation experience.In the cases, the incidence rate of posterior capsular rupture in 2006 was the lowest,and the effect was the best.There was significant dependablity between posterior capsular rupture and the time of operation.4.Vision of the patients without posterior capsular rupture exceed or equal 0.8 was common in the cases.Most In the patients with vision less than 0.5 , the most were relevant with posterior capsular rupture.In this study,the incidence rate of patients whose vision exceed 0.8 and posterior capsular integrity was 84.45%,but that vision exceed 0.8 and posterior capsular rupture was 57.14%.This illustrated the postoperative visual rehabilitation was obviously influenced by posterior capsular rupture among the operation. Conclusions:1.Posterior capsular rupture is the superior and the most frequent operational complication in phacoemulsification. It leads to harmful effects for the next operation and the visual rehabilitation of the patient.2.Age is conspicuous correlate with the happening of posterior capsular rupture.With the increases of the ages,the incidence rates of posterior capsular rupture are growing.3.Most posterior capsular rupture is connected with the operating damage.The rud operative procedure and the redundant suction of the remaining cortices are prone to lead to posterior capsular rupture.So the important factors preventing to posterior capsular rupture are the cases of the suitable selections and the expert operating procedures in every phases in phacoemulsification.With the evolvement of phacoemulsification,the accumclation of the surgical technics and the experiences of the operators, the incidence rates of posterior capsular rupture are descendent.4.The important measures to elevate the operational effects and to reduce complications are the timely and correct treatments.If the operator can deal with phacoemulsification correctly,the patients still could be embedded intraocular lens.So that the severe operational complications can be avoided,and the patients still could have the good postoperative visual rehabilitations.