Sir,
We greatly appreciate Subash's kind comments. Osher et al1 reported a 26% incidence of capsule rupture in a series of 31 cases and Vasavada2 reported a 36% incidence in his 22 cases. As we know with newer technique the reported rate of posterior capsule rupture has been reduced. For example, Hayashi3 showed low incidence of posterior capsule rupture (only 7.1).
In our study, there was not any co-existent or previous ocular disease (except two eyes with retinitis pigmentosa) or surgical intervention, which may influence surgical outcome. We have not any special exclusion criteria. We performed our procedure based on the technique that Dr Allen described.4 Although it was better to conduct a randomised control trial, but our results was remarkable enough to document the safety and efficacy of the procedure.
We think in most cases the capsule underlying posterior cataract is not absent but tends to be unusually weak and this weakness could predispose to posterior capsular rupture with only a minimal trauma. So optimal surgery and avoiding the ‘floppy’ posterior capsule during operation may reduce posterior capsular rupture to nearly zero.
References
Osher RH, Yu BC-Y, Koch DD . Posterior polar cataracts: a predisposition to intraoperative posterior capsule rupture. J Cataract Refract Surg 1990; 16: 157–162.
Vasavada A, Singh R . Phacoemulsification in eyes with posterior polar cataract. J Cataract Refract Surg 1999; 25: 238–245.
Hayashi K, Hayashi H, Nakao F . Outcomes of surgery for posterior polar cataract. J Cataract Refract Surg 2003; 29: 45–49.
Allen D, Wood C . Minimizing risk to the capsule during surgery for posterior polar cataract. J Cataract Refract Surg 2002; 28: 742–744.
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Moghimi, S., Siatiri, H. Reply. Eye 21, 675 (2007). https://doi.org/10.1038/sj.eye.6702685
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DOI: https://doi.org/10.1038/sj.eye.6702685