ABSTRACT
Anterior capsulotomy is a key step in cataract surgery. Here we report our experience with two techniques, namely can-opener capsulotomy [COC] and continuous curvilinear capsulorhexis [CCC]. Which technique is chosen is partly influenced by the type of cataract present: it was mature in 52.1%, immature in 42.2%, and associated with pseudoexfoliation in 5.8% of cases. Posterior capsular tears occurred in 7% of all operations [7.8% of all 90 cases of COC, and 5.8% of all 52 cases of CCC]. Five of the total of 10 posterior capsular breaks occurred in eyes with mature cataract [a rate of 6.8%], 2 in eyes with immature cataract [a rate of 3.3%], and 3 in eyes with pseudoexfoliation [a rate of 37.5%]; this stresses the significance of local population factors among the causes for the relatively high rate of capsular rupture experienced by us. Of all posterior capsular breaks, 70% happened during the phase of irrigation and aspiration of cortical material. This step was most dangerous in the group operated using the COC technique. Six out of seven cases [85.7%] of posterior capsular rupture in this group happened during irrigation and aspiration of cortex. While in the group operated using the CCC technique, the risk of posterior capsular rupture was equally divided between nucleus delivery, irrigation/aspiration and intra -ocular lens implantation [one case for each step]