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LETTER TO EDITOR
Year : 2007  |  Volume : 55  |  Issue : 1  |  Page : 77

The need of prediction of posterior capsular plaques


Ajay Nagar, Ajmer - 305 001, India

Correspondence Address:
Leena Barikh
Ajay Nagar, Ajmer - 305 001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.29506

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How to cite this article:
Barikh L. The need of prediction of posterior capsular plaques. Indian J Ophthalmol 2007;55:77

How to cite this URL:
Barikh L. The need of prediction of posterior capsular plaques. Indian J Ophthalmol [serial online] 2007 [cited 2024 Mar 29];55:77. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?2007/55/1/77/29506

Dear Editor,

My congratulations to Vasavada et al .[1] for bringing out some facts on posterior capsular plaques in patients with posterior subcapsular cataract. The article speaks about the predictability of posterior capsular plaques; however, it fails to tell the utility of the same.

The authors report that the prediction was correct in 88.6% of cases.[1] Cohen's kaapa value is 0.72, suggestive of good agreement.[1] However, a simple sensitivity and specificity test rather than Cohen's test would have helped a general ophthalmologist in knowing the predictive value and understanding that figure better.

Data on the age and sex of the patients have been collected but no comparison is drawn on whether there is any factor related to that.

Authors themselves agree that they had done that for only posterior subcapsular cataract.[1] Since it is known that such plaques may be associated with other types of cataracts[2],[3] the results should be analyzed cautiously. In a clinical setting, this would be totally different and various types of cataracts would be available.

Now let's come to the important point. Should these capsular plaques be removed in adults? As per the authors this should not be done and it is not required.[1] Do they affect the visual acuity? Not much.[2] Is there any data on postoperative visual acuity in the study? Again in the negative.[1] So the statement that there would be limitation of visual acuity doesn't stand. In a previous article, it has been proved that none of the patients actually complained of visual disability and avoided YAG capsulotomy.[2] The authors themselves believe that YAG may not be necessary. Posterior capsular plaques should not be removed and they are not visually bothersome. So even if we identify them there is nothing we would be doing since nothing should be done. The question, therefore, regarding the utility of the whole study is compromised. I believe that the three limitations of the study, which the authors rightly point out in the end, should have been addressed.

 
  References Top

1.
Vasavada AR, Praveen MR, Jani VD, Shah SK. Preoperative prediction of posterior capsule plaque in eyes with posterior subcapsular cataract. Indian J Ophthalmol 2006;54:169-72.  Back to cited text no. 1
    
2.
Vasavada A, Chauhan H, Shah G. Incidence of posterior capsular plaque in cataract surgery. J Cataract Refract Surg 1997;23:798-802.  Back to cited text no. 2
    
3.
Mootha VV, Tesser R, Qualls C. Incidence of and risk factors for residual posterior capsular opacification after cataract surgery. J Cataract Refract Surg 2004;30:2354-8.  Back to cited text no. 3
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