A break in the posterior capsule of the ocular lens may occur following perforating ocular trauma. Vajpayee et al identified two patterns of posterior capsular break. The authors are from the All India Institute of Medical Sciences in New Delhi.
The breaks may be central or peripheral.
The breaks may be have different shapes:
(1) circular
(2) linear
(3) elliptical
(4) oval
(5) crescentic
Feature
Type I Break
Type II Break
time between trauma and surgery
long interval (months)
short interval (days)
margin of break
thickened and fibrosed
thin
effect of irrigation on the size of the break
no effect
rapid enlargement of break
posterior capsule
opaque
transparent
traumatic cataract
thin and partially absorbed
lens thickness normal
Type I breaks:
(1) require a primary posterior capsulectomy
(2) aspiration of cortical material is easily performed with a routine irrigation/aspiration technique
In the absence of complicating factors the authors recommended waiting at least 6 weeks before performing surgery, since this allowed a Type I break to develop.
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