الفهرس 
Mangment of posterior capsular tearOnly 14 pages are availabe for public view
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Abstract
Posterior capsule rupture is a major complication during cataract surgery. There are many risk factors that enhance its occurrence such as : - high myopia – small pupil - older age.
Type and etiology of cataract ,Surgical technique and skills of the surgeon with the learning curve and experience.
Signs of posterior capsular rupture include deepening of the anterior chamber, decreased mobility of nuclear pieces, dyscoria, a lateral displacement of nuclear fragments and incarceration of the vitreous strands in the suction port of the cannula
During ECCE the causes of posterior capsule tear include the smaller incision, trauma during capsulotomy, injury to the posterior capsule during irrigation–aspiration, and high pressure from the posterior chamber.
During phacoemulsification posterior capsular tear can occur during any stage of surgery, most frequently during the stage of nuclear emulsification, and during irrigation–aspiration.
An irregular capsulorhexis can lead to posterior capsular tear
Performance of vigorous hyDROProcedures in the presence of anterior capsular tears, during nuclear management
Poor finishing of the irrigation–aspiration tip can also cause a posterior capsule tear.
Excessive pressure on the distal loop due to insertion or rotation of the IOL at an incorrect angle can also cause a posterior capsule tear.
The incidence of posterior capsule tears in posterior polar cataract ranges from 26% to 36%, two main causes for this tear (Extraction exerted on the plaque adherent to the posterior capsule and an inherent weakness of the posterior capsule). If the margins of the posterior capsule tear are not smooth, a posterior capsulorhexis may be undertaken.
If the nucleus is hard, Phaco-chop technique is preferred as it minimizes capsular stress, cortical removal is completed using low infusion to minimize the risk of vitreous herniation.
Primary posterior capsulorhexis consists of creating a circular opening in the posterior capsule for the purpose of preventing opacification of the posterior capsule and converting irregular posterior capsule tear into smooth-edged defect .
During ECCE, posterior capsule tears should be plugged with a viscoelastic substance. Plugging and dry aspiration of the remaining cortical lens matter prevents further enlargement. control of infusion, establishment of semiclosed system, and avoidance of overhydration of the vitreous prevent enlargement of the tear .
During phacoemulsification, if a large posterior capsule tear occurs during early stages the procedure should be converted to an ECCE.
In the later stages of phacoemulsification, the posterior capsule tear can occur with or without hyaloids face intact with or without the subluxation of nuclear material.
If the tear is small or if the margins are visible with no vitreous prolapse, the -IOL may be implanted in PC, if the capsular rim (anterior or posterior) is available posterior IOL can be placed in the sulcus over the remnants of capsule, and if the tear is large or margins of the tear are not visible the IOL implanted in Anterior chamber or fixated to the Iris or Sclera.
To prevent posterior capsule tear there’s some precautions and modifications such as achieving a soft eye, Modification of the ECCE , phaco and IOL implantation technique.
For eyes that suffered a posterior capsular tears provide more antibiotic, and all patients whose posterior capsule ruptured should undergo a careful, peripheral, indented retinal exam within 2 to 4 weeks of cataract surgery.