Radial Tear During Cataract Surgery?

👁 What is a Radial Tear During Cataract Surgery?

A radial tear is a complication in which the anterior capsule tears outward in a radial pattern
during CCC (Continuous Curvilinear Capsulorrhexis) in cataract surgery.

 

 

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🔍 Normal Cataract Surgery Steps

1. Corneal Incision
2. CCC – Circular tear in the anterior capsule
3. Phacoemulsification – Lens emulsification & removal
4. IOL Implantation – Lens placed in intact posterior capsule

✅ Posterior capsule must remain intact
❌ If the radial tear extends posteriorly → poor outcome

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⚠ Risks of Radial Tear

• May propagate to the lens equator or posterior capsule
• Can progress into bilateral radial tears
  → known as the Argentina Flag Sign

📊 Marques Study (2006):

• <1% incidence
• Among those:
  • 48% extended to posterior capsule
  • 19% required anterior vitrectomy

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🛠 Management Strategy

SituationResponse

Tear detected early	Stop CCC → Fill with cohesive OVD
New CCC	Start in opposite direction (clockwise), outside-in
If unsuccessful	Use can-opener capsulotomy technique
If stabilized	Proceed with IOL implantation

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✅ Summary

• CCC integrity is key to surgical success
• Radial tears must be quickly recognized and managed
• Prevention through technique & awareness is most effective