A 60-year-old patient undergoing phacoemulsification is found to have a dense, white, disc-shaped opacity located precisely at the posterior pole of the lens, abutting the posterior capsule. Which statement best describes the key surgical consideration?

• A It is associated with weak zonules requiring capsular tension ring
• B It is typically associated with posterior synechiae and uveitis
• C It is best managed with Nd:YAG laser capsulotomy
• D The posterior capsule is often thin or dehiscent, carrying a high risk of intraoperative rupture ✓

Explanation

Posterior polar cataract features a dense, white, disc-shaped opacity at the posterior pole adherent to a thin or dehiscent posterior capsule. This anatomical relationship makes posterior capsule rupture a major intraoperative risk during phacoemulsification. Surgeons should avoid aggressive hydrodissection and may employ techniques like posterior capsulorhexis or leaving a peripheral shell of nucleus to protect the capsule and prevent vitreous loss.

Reference: AAO Basic and Clinical Science Course, Section 11: Lens and Cataract, 2023-2024 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.