Purpose: To evaluate the feasibility and the risks of posterior capsulorhexis.
Material and methods: Retrospective analysis of 504 cases operated by phacoemulsification or manual extracapsular cataract extraction with a circular posterior capsulectomy. These cataracts were due to age or of unknown etiology. We analysed the intraoperative and postoperative complications. Fluorescein angiography was performed in a sample of unselected cases.
Results: The intraoperative complications consisted in 5 uncontrolled tearing and 7 prolapses of vitreous (4 of the 7 only in the posterior capsulectomy). Eleven of these twelve incidents occurred in case of positive posterior pressure. In the postoperative period, 3 additional prolapses of the vitreous in the pupil were observed; two of these capsulorhexis had been made larger than the optic of the intraocular lens. Three eyes with 25.79; 34.69 and 26.3 mm axial length presented a retinal detachment. Among 49 cases submitted to fluorescein angiography, 3 showed cystoid macular edema.
Conclusions: Posterior capsulorhexis would be feasible in the cataract-implant surgery in adults, except in case of positive pressure. The diameter of the capsulorhexis has to be smaller to the diameter of the intraocular lens optic.