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PubMedDate not supplied

Endophthalmitis: immediate management using posterior capsulorhexis and anterior vitrectomy through reopened cataract surgery incision.

An alternative tap/biopsy technique for early management of endophthalmitis is described. The technique uses the cataract surgery wound for anterior chamber washout and for a posterior continuous curvilinear capsulorhexis through which anterior vitrectomy, removal of part or all the vitreous abscess, and injection of antibiotics can be performed. The approach is safe, avoids pars plana incisions, and maintains capsule support for the intraocular lens or for removal and reimplantation of a posterior chamber lens in the bag.

Aged↗
PubMed1997

Intraoperative and postoperative complications of high-frequency capsulotomy and continuous curvilinear capsulorhexis.

PURPOSE: To compare the intraoperative complications and postoperative blood-aqueous barrier (BAB) disturbance after high-frequency capsulotomy and continuous curvilinear capsulorhexis (CCC). SETTING: Vienna General Hospital, Vienna, Austria. METHODS: This prospective, randomized clinical study evaluated 53 eyes with senile cataract. Patients were divided into two groups: high-frequency capsulotomy (n = 27) or CCC (n = 26). The surgical procedure and postoperative therapy were standardized for both groups. The intraoperative course was documented, and postoperative complications were examined by biomicroscopy 3 months postoperatively. Without the pupil dilated, BAB disturbance was evaluated with a laser flare-cell meter at 1, 3, 7, and 14 days postoperatively. The findings were analyzed statistically. RESULTS: Intraoperatively, the high-frequency capsulotomy group had a significantly higher rate of radial tears in the anterior lens capsule. Postoperatively, this resulted in a higher incidence of postoperative false positioning of the intraocular lens. At no time were the flare-cell meter results between groups statistically significant. CONCLUSION: High-frequency capsulotomy resulted in no more trauma than CCC. It can be a good alternative to conventional techniques, particularly in eyes with no red reflex. However, the technique is associated with less mechanical stability.

Aged↗
PubMed1997

Forceps-puncture continuous curvilinear capsulorhexis.

Forceps-puncture continuous curvilinear capsulorhexis uses a single instrument. Using less instrumentation during the procedure decreases the chance of inadvertent damage to ocular structures and reduces surgical time. Complications related to this technique are rare.

Cataract Extraction↗
PubMed1997

Change in capsulorhexis size after implantation of three types of intraocular lenses.

PURPOSE: To compare the change in size of continuous curvilinear capsulorhexis (CCC) used for implantation of three types of intraocular lenses (IOLs) and to determine the role of postoperative inflammation, initial CCC dimension, haptic design, and optic material. SETTING: Hôpital Ophtalmique Universitaire Jules Gonin, Lausanne, Switzerland. METHOD: Twenty-nine three-piece, silicone/poly(methyl methacrylate) (PMMA) IOLs (lovision 127), 26 one-piece PMMA IOLs (Pharmacia 812A), and 27 plate-haptic silicone IOLs (Staar AA4203) were implanted in the capsular bag after phacoemulsification. Photographs of the CCCs taken 1 day and 6 months after surgery were scanned and digitized on a computer. Using different software, the surface of the CCC was measured and the 6 month change evaluated. Flare, measured the day before surgery and postoperatively at days 1, 7, 30, and 180, was integrated to obtain a global estimate of inflammation during the 180 day follow-up. RESULTS: The CCCs used with three-piece, silicone/PMMA IOLs showed little changes in surface, with a mean enlargement of +0.57 mm2 +/- 1.15 (SD) (+3.5%). The CCCs used with the one-piece PMMA IOLs had a slight tendency to constrict, with a mean surface decrease of -0.59 +/- 2.16 mm2 (-4.3%). The CCCs used with plate-haptic silicone IOLs showed a marked and statistically significant constriction, with a mean decrease of -2.55 +/- 3.51 mm2 (-14.4%). The change in CCC size was not associated with the integrated flare, and no correlation was found between the initial CCC size and the magnitude of change. There was no statistically significant difference in CCC change between the PMMA optic IOL (Pharmacia) and silicone optic IOL (lovision and Staar) groups. The CCC in the plate-haptic IOL (Staar) group showed a significant (P < .0002) constriction when compared with that in the loop-haptic IOL (Pharmacia and lovision) group. CONCLUSION: The IOLs' haptic design seemed to play a major role in the evolution of the CCC. The CCC constriction seen with the Staar IOLs was related to their plate haptics.

Aged↗
PubMed1993

Continuous curvilinear (circular) capsulorhexis and planned extracapsular cataract extraction--are they compatible?

The successful use of continuous curvilinear (circular) capsulorhexis (CCC) in planned extracapsular cataract extraction (ECCE) is dependent on the feasibility of safe nuclear delivery through the smaller anterior capsular opening. Experimental evidence supports the proposition that the anterior capsular rim can stretch without tearing to dimensions which allow for safe nucleus delivery. Clinical reports of accidental intracapsular expression during nucleus delivery in CCC seemingly contradict the experimental evidence. This paper examines this apparent contradiction and presents clinical evidence in the form of a series of 210 cases of planned ECCE with CCC. The technique used and a detailed analysis of the operative complications are presented. The results indicate that using a modified technique for nucleus delivery, CCC and planned ECCE are fully compatible techniques.

Adult↗
PubMed1994

Capsulorhexis contracture in phacoemulsification surgery.

We report two cases of capsulorhexis contracture and eventual complete closure after phacoemulsification surgery. The closures significantly decreased vision, but vision improved in both cases following successful Nd:YAG laser treatment.

Adult↗
PubMed1994

[Capsulorhexis and manual extracapsular extraction of the crystalline lens. Theoretical and practical considerations].

Four cases of inadvertent intracapsular lens delivery secondary to zonular lysis occurring during planned manual extracapsular cataract extraction were reported. Theoretical and practical considerations were presented based on these observations and literature review. These considerations would suggest relaxing incisions when capsulorhexis and planned extracapsular cataract extraction are associated.

Aged↗
PubMed1995

Retinal detachment following cataract surgery with capsulorhexis.

PURPOSE: To estimate the incidence of retinal detachment after cataract surgery with capsulorhexis. METHODS: A consecutive series of 2,150 cataract operations were followed for incidence of retinal detachment. A series of 1,000 patients from this group were analyzed for high risk factors: myopia, age, sex, operative complications and capsulotomy. RESULTS: With minimum one year follow up in 90% of patients the incidence of retinal detachment was 0.25% (5 cases). CONCLUSION: The true incidence of retinal detachment after cataract surgery remains elusive. There is probably a trend toward lower incidence compared to previous reports.

Adult↗