Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Capsulorhexis”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMed1998

New classification of capsular block syndrome.

PURPOSE: To propose a new classification of capsular block syndrome (CBS) to improve understanding of the etiology and provide effective treatment. SETTING: Shohzankai Medical Foundation, Miyake Eye Hospital, Nagoya, and Japanese Red Cross Society, Wakayama Medical Center, Wakayama, Japan. METHODS: Three groups of eyes with CBS were reviewed: eyes originally reported and diagnosed as having CBS; eyes experiencing CBS after hydrodissection and luxation of the lens nucleus; and eyes with CBS accompanying liquefied aftercataract or capsulorhexis-related lacteocrumenasia. RESULTS: In all 3 groups, the CBS occurred in eyes with a continuous curvilinear capsulorhexis (CCC). It was characterized by accumulation of a liquefied substance within a closed chamber inside the capsular bag, formed because the lens nucleus or the posterior chamber intraocular lens (IOL) optic occluded the anterior capsular opening created by the CCC. Depending on the time of onset, CBS can be classified as intraoperative (CBS seen at the time of lens luxation following hydrodissection), early postoperative (original CBS), and late postoperative (CBS with liquefied aftercataract or lacteocrumenasia). The etiology of the accumulated substance and the method of treatment are different in each type. CONCLUSION: Capsular block syndrome is a complication of cataract/IOL surgery that can occur during and after surgery. Correctly identifying the type of CBS is crucial to understanding the nature and effective treatment of this disorder.

Capsulorhexis↗
PubMed1998

Phacoemulsification and combined management of intraocular silicone oil.

We report two techniques in which cataract extraction is carried out by phacoemulsification through a corneal incision. If silicone oil is to be removed, a posterior continuous curvilinear capsulorhexis is performed, allowing aspiration of oil through the capsulorhexis followed by lens implantation into the remaining capsular bag. If silicone oil is to be left in situ, the remaining capsule is removed, converting the cataract extraction to an intracapsular-type procedure that retains the advantages of small incision surgery. These techniques offer good improvement in vision and retinal view with more rapid rehabilitation than conventional large incision surgery. The 20% retinal redetachment is comparable to that of other studies and we have not encountered any other significant complications with these techniques.

Adult↗
PubMed1999

Phacoemulsification of white hypermature cataract.

PURPOSE: To evaluate the safety of phacoemulsification of white hypermature cataract, which is common in developing countries. SETTING: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. METHODS: In a teaching hospital setting, a prospective evaluation of phacoemulsification in 25 eyes of 25 consecutive patients with hypermature cataract was done. Patients with good pupil dilation, optimal endothelial cell count, and disease-free ocular and systemic status were included. High magnification, sodium hyaluronate, and a Utrata capsulorhexis forceps were used to perform continuous curvilinear capsulorhexis (CCC). The stop and chop technique was used for nuclear emulsification. A 5.5 mm optic allpoly(methyl methacrylate) intraocular lens (IOL) was implanted, and wound closure was sutureless. RESULTS: Successful CCC was performed in 23 of 25 cases. In 2 cases, the CCC edge extended toward the periphery and a Vannas scissors was used to achieve an even cut. No complications were seen during nuclear emulsification and IOL implantation. Eighty percent of the patients had a visual acuity of 20/40 or better on the first postoperative day. Five patients had significant corneal edema that resolved within 1 week in all cases. CONCLUSION: Phacoemulsification was successfully and safely performed in appropriately selected patients with white hypermature cataract.

Aged↗
PubMed1999

Experimental staining of the anterior lens capsule in albino rabbits.

PURPOSE: To study the value and safety of staining the anterior lens capsule in albino rabbits. SETTING: Ophthalmology Department, Cairo University, and Ophthalmic Pathology Department, Research Institute of Ophthalmology, Cairo, Egypt. METHODS: The experiment was divided into 3 stages. First, the capacity of different concentrations of crystal violet solution to stain the anterior lens capsule of postmortem albino rabbit eyes was tested. The toxicity of different concentrations of the dye (2% to 0.25%) was then tested to determine the highest concentration that was nontoxic to the cornea and trabecular meshwork. The third step was to detect possible toxicity of lower concentrations (0.1% to 0.05%). Different dye concentrations were injected into the anterior chamber of the rabbit eyes. The eyes were examined after 1 and 3 days, 1 week, and 1 month using light microscopy and scanning and transmission electron microscopy. RESULTS: Different concentrations of crystal violet stained the anterior lens capsule, allowing for easy capsulorhexis. The use of the 2% and 1% concentrations was accompanied with irreversible damage to all corneal layers. The use of the 0.5% concentration caused damage to stromal keratocytes and endothelium. The use of the 0.25% concentration did not damage any corneal layer or the trabecular meshwork. Lower concentrations of 0.1% and 0.05% also stained the capsule, providing good visibility for successful capsulorhexis, and were less toxic to the corneal endothelium. CONCLUSION: Staining the anterior lens capsule with 0.25% to 0.05% concentrations of crystal violet solution caused no injury to the cornea or trabecular meshwork in albino rabbit eyes.

Animals↗
PubMed2000

Early postoperative capsular block syndrome related to saccadic-eye-movement-induced fluid flow into the capsular bag.

PURPOSE: To determine the relationship between saccadic eye movements and the development of early postoperative capsular block syndrome. SETTING: Fundacion Oftalmologica, Los Andes, Santiago, Chile. METHODS: An artificial experimental setup was designed to reproduce the anatomical, hydrodynamic, and kinetic conditions of an early postoperative pseudophakic eye with a capsulorhexis and intracapsular intraocular lens (IOL) implantation. An electromechanical transducer driven by a digital-to-analog converter was used to mimic saccadic eye movements at physiological speeds and accelerations. Position information and differential pressure measurements between the intracapsular space and the extracapsular space were digitized. Various anterior capsule-IOL configurations were tested including partial adhesion of the anterior capsule to the lens. RESULTS: Saccadic movements increased intracapsular pressure by displacing fluid into the capsular bag. This finding was inconstant and only observed when the capsular rim adhered to the IOL optic by more than 70%. Development of positive intracapsular pressure was noted above 4 mm Hg. CONCLUSION: A valve-like mechanism formed by the capsulorhexis rim partially adhered to the IOL optic can occur postoperatively. Under these conditions, saccadic eye movements can increase intracapsular pressure by a unidirectional inertial displacement of fluid into the capsular bag.

Aqueous Humor↗
PubMed2000

The phacoemulsification learning curve: per-operative complications in the first 3000 cases of an experienced surgeon.

PURPOSE: To assess the per-operative complications occurring during the first 3000 phacoemulsification cases performed by an experienced consultant surgeon. METHODS: A prospective analysis of 3000 consecutive cases performed without supervision between November 1992 and November 1998 was carried out. Data recorded for each case included details of per-operative complications, pre-operative best corrected visual acuity, nuclear density, history of previous pars plana vitrectomy, and whether phacoemulsification was performed as part of a phacotrabeculectomy procedure. RESULTS: The overall rate of vitreous loss was 1.3%. Nuclear fragments were lost to the vitreous in 6 cases (0.2%). The initial rate of vitreous loss was 4.0% in the first 300 cases falling to 0.7% in the last 300 cases. Capsulorhexis failure was the commonest per-operative complication observed, but the risk of subsequent posterior capsule rupture fell significantly from 9 of 45 (20.0%) in the first 100 cases to 1 of 49 (2.0%) in the next 2000 cases (p = 0.0061, Fisher's exact test). There was a significant increase in risk with denser cataracts, especially for capsulorhexis failure, rising to over 35% in the densest cases. The increases in posterior capsule rupture and vitreous loss were less dramatic but nonetheless very significant. There was no significant increase in the risk of per-operative complications with phacotrabeculectomy, and no increased risk in patients who had previously undergone pars plana vitrectomy. Posterior capsule rupture occurred in 22 of 612 (3.6%) local anaesthesia cases compared with 31 of 2269 (1.4%) topical anaesthesia cases. Per-operative best corrected visual acuity of 6/9 or better was recorded in 2.0% of the first 1000 cases compared with 13.9% of the last 1000 cases. CONCLUSIONS: (1) Per-operative surgical risks could be reduced to low levels during the learning curve, but complications continued to occur at a low frequency. (2) The risk of per-operative complications was not significantly elevated in previously vitrectomised eyes. (3) Nuclear density correlated significantly with per-operative complication risk. (4) The visual threshold for cataract surgery fell dramatically with increasing experience of phacoemulsification. (5) Topical anaesthesia was not associated with an increased risk of per-operative complications.

Anesthesia, Local↗
PubMed1998

[Capsulotomy in intumescent cataract with the high frequency diathermy capsulotom].

BACKGROUND: Intumescent or hypermature cataracts sometimes mean a difficult capsulorhexis. High frequency capsulotomy represents a satisfying solution for this problem. PATIENTS AND METHODS: 26 patients with intumescent cataracts undergoing cataract surgery with high frequency capsulotomy were enclosed into this study. Clinical application of this technique was examined intraoperatively and postoperatively. RESULTS: Only in 4 patients out of 26 it was not possible to achieve a circular cut by capsulotomy. Residual bridges could be cut by scissors. CONCLUSIONS: High frequency capsulotomy means a convenient alternative to capsulorhexis, while correct technique intraoperatively is extremely important for satisfying clinical results.

Aged↗
PubMed2005

Centripetal lens epithelial cell migration: a prospective study of the Alcon SA60AT intraocular lens.

PURPOSE: To evaluate prospectively the incidence and severity of centripetal lens epithelial cell migration (CLECM) onto the anterior surface of the Alcon SA60AT intraocular lens (IOL). METHODS: One hundred and four consecutive cases of SA60AT IOL implantations were prospectively evaluated. At the 1-month postoperative visit, best corrected visual acuity (BCVA) was obtained. Following maximal pupillary dilatation, the extent of CLECM was assessed using a simplified grading scale (0-4). The centrality of the lens within the capsular bag was recorded. Patients with the highest grade of CLECM were recalled for reassessment at a minimum of 3 months. RESULTS: Centripetal lens epithelial cell migration data were obtained on 99 patients. Of these, 94% demonstrated CLECM of varying severity at 1 month postoperatively. The severity was low grade in 54% of patients (29% grade 1, 24% grade 2), and high grade in 40% of patients (16% grade 3, 24% grade 4). BCVA results were good (91.9% 6/6 or better) and did not correlate with CLECM grade. Operative capsulorhexis size did not correlate with the severity of CLECM. The lens was well-centred in 91 of 92 patients in whom lens position was assessed. Twenty-three patients with grade 4 CLECM at 1 month were brought back for reassessment (3.5-13 months postoperatively) and 18 of these demonstrated complete regression of CLECM (to grade 0). CONCLUSIONS: There is a high incidence and severity of CLECM 1 month postoperatively using the Alcon SA60AT IOL. There was no significant correlation between CLECM grade and either BCVA at 1 month, capsulorhexis size or lens centration. CLECM appears to be a frequent, benign and transient event with this lens.

Acrylic Resins↗
PubMed2006

Evaluation of the effects of hydrodissection with antimitotics using a rabbit model of Soemmering's ring formation.

BACKGROUND: Regeneration/proliferation of lens material within the capsular bag still is the most frequent complication after cataract surgery. We aimed to evaluate the effects of hydrodissection with low doses of antimitotics on the overall regeneration/proliferation of lens material in rabbit eyes, using a model allowing the lens material to be confined to the equatorial region of the capsular bag, facilitating its quantification. METHODS: Twelve albino rabbits underwent bilateral phacoemulsification. Their eyes were randomized to receive 0.4 cc of balanced salt solution, 5-fluorouracil (12.5 mg/mL) or mitomycin C (0.1 mg/mL) during hydrodissection. They were left aphakic, so the capsulorhexis would fuse with the posterior capsule postoperatively. After 4 weeks, killing/enucleation was performed. Regeneration/proliferation of lens material within the equatorial capsular bag (Soemmering's ring) was graded from the Miyake-Apple view (0-4). Its area was also calculated (microm(2)) from direct measurements performed on histological sections. RESULTS: The capsulorhexis margin fused with the peripheral posterior capsule, so the central posterior capsule remained clear. There was no significant difference among the groups (Kruskal-Wallis test) regarding Soemmering's ring gross grading (P = 0.511), number of lens epithelial cell layers lining the inner surface of the capsular bag (P = 0.310) and Soemmering's ring microscopic cross-sectional area (P = 0.638). CONCLUSIONS: The effect of different solutions on after-cataract should be assessed in terms of overall regeneration/proliferation of lens material within the capsular bag, in addition to posterior capsule opacification. When administered in low doses during hydrodissection, 5-fluorouracil and mitomycin C did not show a significant inhibitory effect on after-cataract formation in rabbit eyes.

Acetates↗
PubMed2006

Cystoid macular oedema in paediatric aphakia and pseudophakia.

AIM: To assess the incidence of cystoid macular oedema (CMO), following lensectomy, anterior vitrectomy (limbal and pars plicata), and primary posterior capsulorhexis following surgery for congenital and developmental cataract. METHODS: A prospective study was carried out involving 30 eyes (20 children) with cataract. Lensectomy, primary posterior capsulorhexis, and anterior vitrectomy were performed on all eyes. Vitrectomy was performed using either a limbal or pars plicata approach. Fluorescein angiography was carried out 4-7 weeks after surgery. Fluorescein was administered intravenously and visualised using the Retcam. RESULTS: Anterior vitrectomy was carried out via the limbal approach in 12 eyes and, of these, six were implanted with an intraocular lens. The pars plicata approach was carried out in 18 eyes and 10 received an implant. CMO was not detected in any eye. CONCLUSION: CMO was not detected in the early postoperative period irrespective of approach to anterior vitrectomy or presence of an intraocular lens. Intravenous fluorescein angiography was performed without complication.

Aphakia, Postcataract↗
PubMedDate not supplied

Trypan-blue- and endoillumination-assisted phacoemulsification in eyes with vitreous hemorrhage during combined cataract and vitreous surgery.

PURPOSE: To study the safety and usefulness of trypan blue application and conventional endoillumination for enhancing visualization during phacoemulsification and foldable intraocular lens implantation in cases of cataract with vitreous hemorrhage. METHODS: Ten eyes of 10 patients with cataract and coexisting vitreous hemorrhage underwent combined trypan-blue- and endoillumination-assisted phacoemulsification and foldable intraocular lens implantation with vitrectomy. In a two-step surgery, after staining the anterior capsule with trypan blue, continuous circular capsulorhexis was performed; then, phacoemulsification was performed using conventional endoillumination. Specular microscopy was performed before and 3 months after surgery on eyes that underwent trypan-blue- and endoillumination-assisted phacoemulsification and on control eyes that underwent standard phacoemulsification to evaluate the toxic effect of trypan blue on corneal endothelial cells. RESULTS: Trypan blue application improved visualization of the anterior capsule, and a complete capsulorhexis could be performed in all eyes. In all 10 eyes, endoillumination was required to visualize the lens structure, and phacoemulsification could be accomplished. Specular microscopy revealed that there was no significant difference in the level of corneal endothelial cell loss between the trypan-blue- and endoillumination-assisted phacoemulsification group and the control group. CONCLUSION: The described double visualization technique may assist phacoemulsification in selected cases of cataract with vitreous hemorrhage.

Aged↗
PubMedDate not supplied

Comparison of the clinical performance of Healon 5 and Healon in phacoemulsification.

PURPOSE: Healon 5 is a high-molecular-mass fraction of sodium hyaluronate. Its density endows it with a number of viscoelastic characteristics. In this prospective, randomised clinical study we compared the performance of Healon 5 and Healon in phacoemulsification. SETTING: Institute of Ophthalmology, University of Modena and Reggio Emilia, Italy. METHODS: Two groups of patients underwent phacoemulsification and intraocular lens (IOL) implantation. In the first 27 patients Healon 5 was used as viscoelastic substance during surgery, and in the second 27 Healon was used. The surgeons subjective comments on the performance of these viscoelastic agents were recorded at the different steps of surgery: injection, capsulorhexis, phacoemulsification, IOL implantation, removal of viscoelastic agent and trasparency throughout the operation. The surgeon's overall impression of the viscoelastics during the whole operation was noted. Tonometry and endothelial cell count were performed in all patients before and after operation. RESULTS: There was no statistical difference between the two groups as regards visual acuity, ocular pressure and endothelial damage. Healon 5 showed excellent ability to maintain the anterior chamber during capsulorhexis, phacoemulsification and IOL implantation. Removal time with Healon 5 was not appreciably longer than Healon. CONCLUSIONS: Healon 5 emerges as a very interesting viscoelastic substance. Visibility is better if the anterior chamber is filled completely. Removal is easier if it is aspirated while moving the irrigation aspiration tip with circular movements over the top and around the border of the IOL.

Adult↗
PubMed1999

Two cases of late postoperative capsular block syndrome.

Two cases of late postoperative capsular block syndrome that occurred 4 and 8.5 years, respectively, were encountered. One case underwent phacoemulsification after continuous curvilinear capsulorhexis in his left eye. The other case had a can opener type capsulorhexis and underwent extracapsular cataract extraction with trabeculectomy. One-piece posterior chamber lenses were implanted in both cases. Upon slit-lamp examination, the posterior capsules were found distorted posteriorly; the capsular openings were apparently sealed by the lens optic. A whitish material existed between the intraocular lens optic and posterior capsule, with thick aggregation in a lower fifth space in case 1. After Nd:YAG laser anterior capsulotomy in case 1, the thick aggregate spread diffusely on the posterior capsule which was sunken completely for 4 weeks. After Nd:YAG capsulotomy, the distorted posterior capsule disappeared and the best corrected visual acuity was restored to 20/20 in both cases.

Capsulorhexis↗
PubMed2002

[Surgical management of the capsular contraction syndrome].

PURPOSE/METHODS: To describe a surgical technique to treat severe capsular contraction syndrome. A secondary continuous curvilinear capsulorhexis was performed in four cases of capsular phymosis, attended in our clinic. CONCLUSIONS/RESULTS: All of them resolved with good anatomic and functional results, no recurrence occurred and best correct visual acuity BCVA was preserved after a twelve- month follow-up. This surgical procedure could solve severe capsular contraction syndrome occurring after continuous curvilinear capsulorhexis, phacoemulsification and intraocular lens implantation.

Aged↗
PubMedDate not supplied

Indocyanine green staining for the triple corneal procedure.

BACKGROUND AND OBJECTIVE: In the triple corneal procedure, successful completion of capsulorhexis is of the utmost importance. Another use of indocyanine green dye for better visualization of the anterior lens capsule of mature cataract during the triple corneal procedure is described. PATIENTS AND METHODS: Four consecutive patients (mean age, 69.5 years) with both mature cataracts and corneal opacity underwent the triple corneal procedure. After trephination of the recipient cornea, the anterior capsule of the lens was stained with indocyanine green. A continuous curvilinear capsulorhexis (CCC) was performed, after which conventional triple corneal procedures were followed. RESULTS: In all four cases, this technique markedly improved visualization of the lens capsule and resulted in successful and easy manipulation of the CCC and subsequent removal of residual lens cortex. CONCLUSIONS: Staining of the anterior capsule of mature cataract in the triple corneal procedure clearly defines the border of the capsule, thus allowing easy and complete execution of CCC.

Aged↗
PubMed2004

[Phacoemulsification in white cataract].

PURPOSE: The study presents the technical difficulties of the capsulorhexis and phacoemulsification in the white, intumescent cataract and the incidences occurred during the foldable IOL implantation with the Monarch II injector. METHODS: The clinical study comprises a number of 70 eyes with white intumescent cataract operated during 15 January-15 December 2003 by the same surgeon. The surgical intervention consisted of lens extraction by phacoemulsification with clear corneal incision, using the Monarch II injector for the foldable IOL implantation. In 56 eyes, the anterior capsule was stained with trypan blue. RESULTS: The intraoperative complications include: failed capsulorexis in 4 cases (5.71%), rupture of posterior capsule in 1 case (1.43%) and the conversion to classical extracapsular extraction in 3 cases (4.29%). IOL implantation was made with the help of the Monarch II injector in 67 cases (95.71%). The foldable IOL implantation in the bag was realised a single time in 44 cases (62.9%). We had the following incidences in the other cases: the upside down turning of the IOL during unfolding in 2 cases, the second haptic capture in the tunnel of the cartridge in 2 cases, the second haptic stucks outside or in the anterior chamber in 18 cases, the first haptic stays in the sulcus and the second one stays outside in 1 case. CONCLUSIONS: In eyes with 1 intumescent cataract we can perform the continuous curvilinear capsulorhexis using trypan blue, but also without staining the anterior capsule using mechanical or manual aspiration of the liquefied cortex and viscoelastic substances. The foldable intraocular lens implantation with the injector proves to be an easy and comfortable method after it has been practiced for a longer period of time if the right size of the cartridge is used.

Capsulorhexis↗
PubMedDate not supplied

[The state-of-the-art of surgical treatment of congenital cataract in prematures].

Described in the paper are results of a clinical treatment of 127 children (174 eyes), aged 2 to 15 years, with different-type congenital cataract; the treatment was based on modem technologies including tunnel limbic incision, continuous anterior round capsulorhexis, aspiration-irrigation of the contents of the capsular sac, implantation of soft Acrysof SA30A1 IOLs by forceps or "Monarch" injector and suturing of incision. The anterior continuous capsulotomy was found to be the most complicated surgery stage in removal of congenital cataract in children it could be made without errors in 75.3% of cases. Intracapsular implantation of IOL in different-type cataract in children was possible in 97.7% of cases. The single-unit Acrysof IOL stays stable inside the capsular sac for as long as 24 months. A combination of primary capsulorhexis with "dry" anterior vitrectomy is most effective in the prevention of secondary cataract.

Adolescent↗
PubMed1996

[Results of the intraocular lens SI-30 implantation].

PURPOSE: clinical evaluation of the flexible silicone intraocular lens SI-30 (Allergan). METHOD: retrospective study over 3 years of 2000 implantations of the SI-30 IOL. The lenses were inserted through a 3.2 mm scleral tunnel and placed in the capsular bag after continuous circular capsulorhexis and phacoemulsification. RESULTS: visual outcome was excellent. Without other causes of impaired vision, 99% of patients regained a visual acuity of 20/30 or better after 1 month. Induced astigmatism was unsignificant: 0.4 D; preop., 0.9 D. at day 7, 0.4 at 1 month, 0.5 D. at 1 year. A disinsertion of the inferior haptic occurred in 2 cases during the insertion manoeuver. More specific postoperative complications consisted of pigmented deposits (less than 1%), pupillary capture (4 cases), and capsule contraction associated with small size capsulorhexis. Aspecific complications were: cystoid macular oedema (3% at 1 month, less than 1% afterwards), chronic uveitis (0.6%), acute uveitis (1 patient). CONCLUSION: implantation of the SI-30 silicone lens is safe and gives the patient the benefits of a small, non enlarged, and sutureless cataract incision. The postoperative follow-up must take in account the properties of the lens.

Capsulorhexis↗