PURPOSE: To evaluate postoperative outcomes (in terms of visual acuity, contrast sensitivity, average macular thickness and occurrence of PCO) of the phacoemulsification cataract surgery in adults with and without primary posterior capsulorhexis (PPC).
METHODS: A prospective interventional comparative randomized study included forty-six eyes of twenty-three patients diagnosed with bilateral significant senile cataract. For each patient, one eye was randomly selected to undergo Phaco with PPC (Group I), and the fellow eye underwent conventional Phaco without PPC (Group II). Best corrected visual acuity, contrast sensitivity and intraocular pressure were assessed postoperatively. Ultrasonography and Optical Coherence Tomography were done pre and postoperatively to assess posterior vitreous detachment and average macular thickness. Visual axis opacification (VAO) was recorded (in the Central 3 mm, intermediate 3: 4.5 mm and peripheral: more than 4.5 mm).
RESULTS: There was no statistically significant difference between the two groups as regard visual acuity, contrast sensitivity, IOP and average macular thickness throughout the follow up period. Only 2 (8.7%) cases of group II developed posterior capsule opacification after one year of follow-up (P = 0.261). No intraoperative or postoperative complications were recorded due to primary posterior capsulorhexis.
CONCLUSIONS: Performing PPC is a relatively safe procedure when performed by experienced surgeons. Although there was no statistically significant difference between the two groups regarding BCVA and VAO, but performing PPC, when adopted as routine technique, may prevent further need for Nd:YAG laser capsulotomy which has burdens to the patients.