Posterior Polar Cataract

Ivan Cima, MD, PhD, demonstrates cataract surgery in a 39-year-old patient with congenital posterior polar cataract (approx. 3 mm in diameter). The best corrected Snellen visual acuity was 0.2. Due to the increased risk for intraoperative posterior capsular rupture, the surgery was performed in general anesthesia. The capsulorhexis was made a little bit smaller in case the intraocular lens (IOL) would need to be implanted in the ciliary sulcus. Hydrodelineation and removal of the soft nucleus were performed prior to hydrodissection. Then, the remaining cortex was then carefully viscodissected with dispersive/cohesive OVD. Cortex was gently removed with bimanual irrigation and aspiration using low parameter settings. The posterior capsule remained intact and an aspheric IOL was implanted. On the first postoperative day the uncorrected Snellen visual acuity was 1.0. On slit lamp examination, the IOL was observed in the bag and well centered. A circumscribed primary fibrosis with thinning of the central part of the posterior capsule was noted.

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