Posterior Capsule Rupture: Incidence Rate, Associated Characteristics and Visual Outcomes

Purpose: To see the Incidence rate, Risk factors, Associations, and Visual outcomes of posterior capsule rupture (PCR).  Methods: A cross sectional study was done of all patients with PCR from June to November 2021 in a Tertiary eye care Hospital. In this study, distribution of the respondents by age, the morphology of cataract, risk factors for PCR, Surgeon’s experience, percentage of Phaco and SICS, in which steps of surgery PCR occurred, implantation of IOL following PCR were analyzed. The final visual outcome of cases with PCR was measured.  Results: Among 7650 patients, who underwent cataract surgery during the study period, 142 had eventful cataract surgery with various per operative complications, and PCR was the most common (n = 94). Most of the study population was in the age group 61-70 years (37.2%). About 45% were male, and 55% were female. Among 94 cases, PCR occurred in 65 patients (69.1%) during Phaco and 29 (30.8%) cases during SICS. There was no statistically significant difference between Phaco and SICS for PCR (> 0.05). In most patients (26.1%), PCR occurred during cataract surgeries irrigation and aspiration step. The most common risk factors for developing PCR were small pupil (10.6%) and corneal opacity (9.5%). PCR was higher by trainee surgeons rather than by senior surgeons. There was a statistically significant improvement in postoperative visual acuity even when PCR occurred during surgery (P< 0.001).  Conclusions: PCR occurs in all cataract surgeries and is the main intraoperative complication. This study identified the incidence rate and risk factors of occurring PCR during cataract surgery in a tertiary eye hospital of Bangladesh, which may assist in the application of preventive measures to decrease rates of PCR. Eyes having posterior capsule rupture at the time of cataract surgery have a significant risk of reduced visual acuity.