Posterior polar cataract: Minimizing risks.

BACKGROUND: Comparing surgical outcomes of management of posterior polar cataract, a congenital cataract, which is difficult to manage surgically and has been associated with poor surgical outcomes.

METHODS: 46 eyes of 38 patients with posterior polar cataract underwent phacoemulsification and PCIOL implantation.

RESULTS: In a prospective analytical study, 46 eyes of 38 patients with posterior polar cataracts underwent surgery at a zonal hospital of the armed forces. The posterior polar cataract incidence was 1.23 per 1000 with confidence interval (CI) of 0.0012. Of the 46 eyes operated, 6 had a posterior capsular rupture (PCR) (13.04%). The PCR incidence in normal cataracts is reported at approx. 1.1%, whereas, various studies have reported incidence of 6-36% in posterior polar cataracts. 41 eyes achieved a visual acuity of 6/12 or better (89.13%) and 39 eyes of 6/9 or better (84.78%). 4 patients had amblyopia (8.6%), Two patients developed macular edema (4.34%). Mean follow-up was 7 months (range 3-11 months). There was no case of nucleus drop or retinal detachment.

CONCLUSION: Posterior polar cataracts are a surgical challenge. With controlled surgery, well defined techniques, a good surgical outcome can be achieved with reduced incidence of PCR.