PubMed · 11041722
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M Lavin. 2000. Capsule stabilization with microhooks.. https://doi.org/10.1016/s0886-3350(00)00623-4
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PURPOSE: To evaluate the occurrence of cystoid macular edema (CME) after lens extraction, anterior vitrectomy, and intraocular lens implantation (IOL) in children using angioscopy after administration of oral fluorescein. SETTING: Centers in Tamil Nadu, India, and Hong Kong, China. METHODS: This study comprised 18 children (28 eyes) who had cataract extraction, posterior capsulorhexis, anterior vitrectomy, and in-the-bag IOL implantation. The presence of CME was evaluated 1 week and 4 to 6 weeks after surgery using fluorescein angioscopy. RESULTS: Anterior chamber fibrin occurred in 4 eyes (14.3%). Fluorescein angioscopy was performed 1 week after surgery in all eyes and after 1 month in 25 eyes (89.3%). No eye demonstrated the presence of CME on fluorescein angioscopy. CONCLUSIONS: Cystoid macular edema did not occur in the early period after pediatric cataract surgery using current surgical techniques. Longer follow-up is required to ascertain the incidence of CME in the late postoperative period.
We describe a triple procedure combining corneal transplantation, cataract extraction, and intraocular lens implantation in which the continuous curvilinear capsulorhexis (CCC) is performed in a closed system when corneal transparency is sufficient or using an open-sky method when corneal transparency is poor. With the closed system, the CCC is performed first followed by trephination and hydroexpulsion of the nucleus. A Caporossi coaxial forceps is used to reduce the corneal incision to 1.2 mm, preventing the need for sutures. Tunnel formation, which could limit the size of trephination, is avoided. In addition, endothelial cell loss at the periphery of the recipient cornea is reduced. This technique was performed in 10 eyes without intraoperative complications. With the open-sky method, the CCC is created while counterpressure is applied to the center of the lens with a large spatula, reducing posterior pressure and thus the risk of capsule tear. This technique was performed in 9 eyes without intraoperative complications.
We describe a technique of enlarging a small primary capsulorhexis. Two Sinskey hooks are introduced through the side ports. One hook is placed above the anterior capsulorhexis margin with its tip pointing down, and the other is placed beneath the anterior capsulorhexis margin with its tip pointing up. A small nick is made between the tips of the 2 hooks, and the capsulorhexis is extended with a Utrata capsulorhexis forceps. This technique does not require additional instrumentation, impart zonular stress, or disturb wound architecture or integrity.