Incidence of posterior capsular plaque in cataract surgery

Objective: To determine the incidence of posterior capsular plaque detected during cataract surgery, its association with age and type of cataract, and its impact on vision. Setting: Raghudeep Eye Clinic and Iladevi Cataract & IOL Research Centre, Ahmedabad, India. Methods: This prospective study comprised 256 consecutive eyes having extracapsular cataract extraction with posterior chamber intraocular lens implantation. The presence of plaque on the posterior capsule was noted and charted. Plaque peeling or posterior capsulorhexis was not done at the time of surgery. Mean patient age was 59 years (range 24 to 83 years). Follow-up was up to 1 year. Results: The overall incidence of plaque was 10.16%. The incidence by type of cataract was 5.13%, nuclear sclerotic; 12.50%, posterior subcapsular; 9.68%, mixed; 27.27%, mature (P <.05). The difference in incidence according to cataract type was highly significant between patients older than 50 years and those younger than 50 years (P <.001). At the end of 1 year, 61.54% of patients with plaque maintained a visual acuity of 20/20 to 20/30; 30.77%, 20/40; 7.69%, 20/60 or worse. Conclusion: The incidence of plaque was higher in eyes with mature cataract at any age and in eyes with posterior subcapsular cataract in younger patients. Its presence was compatible with reasonable vision at the end of 1 year.