Less is more when faced with posterior capsular rupture
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KOLOA, Hawaii — Cataract surgeons need to be able to defend their decision to continue operating after posterior capsular rupture and to aggressively chase vitreous floaters, according to a panelist here.
In a panel discussion at Hawaiian Eye 2023, Judy E. Kim, MD, offered advice to cataract surgeons from a retina specialist’s perspective on the best way to proceed after posterior capsular rupture results in vitreous floaters during surgery on rock hard cataracts.
“As a retina specialist, I have to say less is more,” Kim said. “Try not to be aggressive at any stage of handling the vitreous.”
According to Kim, cataract surgeons who choose to continue chasing vitreous floaters may need to be ready to defend their decisions in a court of law if the outcomes are negative.
“Those who are aggressively chasing after these fragments, going deeper than you should, doing maneuvers that are not standard of care and had a bad outcome, were the doctors or defendants who could not defend themselves,” she said. “So my recommendation is, do what you're comfortable with, but you have to be able to defend the core of why you did what you did.”
Kim also suggests that cataract surgeons should refer their patient to a retina specialist as soon as possible.
“You're going to be managing their pressure and making sure the pressure is fine... but as soon as you can, get the patient to your retina colleague. That is that,” Kim said.
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Chang DF. Cataract surgery complications: You make the call. Presented at: Hawaiian Eye 2023; Jan. 14-20, 2023; Koloa, Hawaii.
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