Mechanical Pupil Dilation, Posterior Capsule Rupture, and Cystoid Macular Edema in Illuminated Chopper-assisted Cataract Surgery

Purpose: To evaluate the use of mechanical pupil dilation and capsule staining, and the rate of posterior capsule rupture (PCR) and cystoid macular edema (CME) in illuminated chopper-assisted cataract surgery. Methods: One university hospital, retrospective non-randomized consecutive case series. Six hundred forty-eight eyes of 648 consecutive patients who underwent illuminated chopper-assisted cataract surgery were included in this study. The use of iris hooks and capsule staining, pupil size, operation time, and complications (PCR and CME) were evaluated. Results: In 39 of the 648 eyes (6.02%), the red reflex was insufficient for safe cataract surgery. Of 39 eyes, iris hooks and capsule staining were used in 7 (17.9%) and 1 (2.56%), respectively, while even without any iris hooks or capsule staining, illuminated chopper-assisted capsulorhexis was safely performed in 31 (79.5%) eyes. The rates of PCR and clinically significant CME were 0% (0/648 eyes) and 4.1% (26/648 eyes), respectively. Conclusions: Not only the use of mechanical pupil dilation and capsule staining but also PCR were very low in illuminated chopper-assisted cataract surgery.