Preoperative evaluation of a 55-year-old patient scheduled for phacoemulsification reveals a dense white opacity at the posterior pole of the lens with clear surrounding cortex. The surgeon should be counselled about and prepared for which specific intraoperative hazard?

• A Zonular dialysis requiring a capsular tension ring in every case
• B Inability to achieve adequate mydriasis
• C High likelihood of posterior capsule rupture because the defect may communicate with the capsule ✓
• D Guaranteed need for anterior chamber IOL implantation

Explanation

A posterior polar cataract sits directly over the thinnest part of the posterior capsule, and the opacity may be intimately adherent to or continuous with a pre-existing capsular defect. Hydrodissection must be gentle or avoided because fluid can breach the weak area and cause rupture during nucleus removal. Zonular status and pupillary dilatation are not characteristically affected, and an anterior chamber IOL becomes necessary only if the posterior support is actually lost intraoperatively.

Reference: Kanski's Clinical Ophthalmology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.