Management of posterior capsular rupture in a patient with asteroid hyalosis

Young Bin Song

Meeting:  2015 RANZCO


Date:      -

Session Title: Film

Session Time:      -

Objective/Purpose: To introduce the case of a patient who underwent total vitrectomy to remove prolapsed asteroid hyalosis material in the anterior chamber two weeks after the posterior capsular rupture (PCR) during cataract surgery. Materials/Patients and Methods: A 82-year-old male underwent cataract surgery of his left eye. Phacoemulsification and aspiration was uneventful, but during the chamber formation with ophthalmic viscosurgical device before the intraocular lens (IOL) implantation, the PCR occurred. Prolapsed vitreous was fully removed with anterior vitrectomy and hydrophobic acrylic three-piece-IOL was implanted in the sulcus. The day after the surgery uncorrected visual acuity was 6/9.5 and no vitreous prolapse was noticed. 16 days after the surgery, uncorrected visual acuity dropped to 6/30 due to prolapsed asteroid hyalosis deposits on the anterior surface of the IOL obscuring the visual axis. 23 gauze total vitrectomy was performed. Results and Conclusion: Postoperative recovery was uneventful, and uncorrected visual acuity recovered to 6/7.5. If PCR occurs during cataract surgery in patients with asteroid hyalosis, delayed onset visual acuity decrease could happen, and secondary operation removing prolapsed asteroid hyalosis deposits might be required.