The Efficacy and Safety of Primary Posterior Curvilinear Capsulorhexis in Adult Patients with Cataract: A Retrospective Study

Background: Despite advances in surgical techniques, posterior capsular opacification (PCO) remains a predominant long-term complication of cataract surgery. It results from residual lens epithelial cells (LECs) that proliferate, migrate, and undergo metaplasia within the capsular bag, leading to visual axis obscuration. Clinically, PCO causes reduced visual acuity, diminished contrast sensitivity, and may hinder posterior segment evaluation. The reported incidence of PCO ranges from 20–50% within five years after cataract surgery in adults and approaches nearly 100% in paediatric cases. Although primary posterior continuous curvilinear capsulorhexis (PPCC) is routinely performed in paediatric cataract surgery, its use in adults is limited. PPCC involves the removal of the central posterior capsule at the time of surgery to prevent LEC migration toward the visual axis. Aim: To evaluate the long-term safety and efficacy of phacoemulsification and manual small-incision cataract surgery combined with PPCC and posterior chamber intraocular lens (PCIOL) implantation in adult patients. Materials and Methods: This interventional case series included 50 adult patients who underwent cataract surgery with PPCC at Government General Hospital, Eluru, Between March to July 2025. Only patients with age-related cataract undergoing PPCC were included. Preoperative and postoperative visual outcomes and complications were assessed over a structured follow-up period. Results: The study population comprised 27 females and 23 males. Postoperative corrected distance visual acuity (CDVA) showed significant improvement and remained stable throughout follow-up. No sightthreatening complications such as retinal detachment or endophthalmitis were observed. Conclusion: Cataract surgery combined with PPCC in adults appears to be a safe and effective strategy to reduce PCO, minimize the need for Nd:YAG capsulotomy, and maintain long-term visual outcomes. Further evidence from large-scale randomized controlled trials with extended follow-up is necessary to substantiate these findings.