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At least 109 records · Page 6Linked to original sources
PubMed2006

Suturing a tear of the anterior capsulorhexis.

AIM: To describe a new technique of suturing a tear in the anterior capsulorhexis. METHODS: Continuous curvilinear capsulorhexis (CCC) with lens removal was done in five fresh cadaver eyes. The diameter of the CCC was measured with a calliper. Using the same calliper a tear of the CCC was created while opening the calliper's arms. The distance between the calliper's arms needed to tear the CCC was documented. Using 9-0 Ethilon 9011, CS 160-6 sutures in two eyes, 9-0 Prolene, D-8229, CTC-6L sutures in two eyes, and 10-0 Prolene, 9090, CTC-6 suture in one eye, the tears were sutured. A tear in the CCC was created again in the same way as the first tear. The distance between the calliper's arms needed to tear the CCC was documented again. RESULTS: Suturing of the tear restored some of the strength/elasticity of the CCC. Better results were found while using the 9-0 Prolene, D-8229, CTC-6L sutures than with the two others sutures. CONCLUSIONS: Suturing of a broken CCC can restore at least some of the strength/elasticity of the CCC. This can be important before intraocular lens (IOL) implantation for the safety of the implantation or after the implantation to ensure proper fixation of the IOL.

Biomechanical Phenomena↗
PubMedDate not supplied

Posterior continuous curvilinear capsulorhexis with and without optic capture of the posterior chamber intraocular lens in the absence of vitrectomy.

PURPOSE: To evaluate the efficacy of posterior continuous curvilinear capsulorhexis (PCCC) with optic capture of the posterior chamber intraocular lens (PC IOL) in the absence of vitrectomy in preventing secondary opacification of the visual axis following pediatric cataract surgery. PATIENTS AND METHODS: Thirty-four eyes of 28 children with congenital or developmental cataract, aged 1.5 to 12 years (mean, 6.39 years), were included in this prospective, randomized study. Anterior continuous curvilinear capsulorhexis (ACCC) with PCCC without optic capture of the PC IOL was performed in group A (18 eyes) and ACCC with PCCC with optic capture of the PC IOL was performed in group B (16 eyes). None of the eyes underwent anterior vitrectomy. Secondary opacification of the visual axis, visual acuity, and possible complications were observed and analyzed. RESULTS: The follow-up period ranged from 8 to 28 months (mean, 17.5 months). All 16 eyes (100%) in group B had a clear visual axis at the end of follow-up. Eight eyes (44.4%) in group A had significant opacification of the visual axis. The difference between the two groups was statistically significant (P = .0011). No eye in group B required secondary intervention, whereas all 8 eyes in group A with significant secondary opacification required secondary intervention. There was no statistically significant difference in other complications such as anterior chamber reaction, fibrin formation, lenticular precipitates, and posterior synechiae. The final best-corrected visual acuity at the end of follow-up was comparable in the two groups (P > .05). CONCLUSION: PCCC with optic capture of the PC IOL prevents secondary opacification of the visual axis even in the absence of vitrectomy.

Capsulorhexis↗
PubMedDate not supplied

Enhanced visualization of capsulorhexis with indocyanine green staining in pediatric white cataracts.

PURPOSE: To evaluate the enhancement of the visualization of the anterior lens capsule with indocyanine green (ICG) in pediatric dense, mature cataracts. PATIENTS AND METHODS: Six children (10 eyes) 4 to 9 years old with complete, white cataracts underwent ICG-enhanced cataract surgery. RESULTS: All of the eyes showed a complete continuous curvilinear capsulorhexis and a well-centered intracapsular implant. No surgical or postoperative complications were encountered. CONCLUSION: Staining the anterior capsule with ICG is an excellent way to facilitate performance of an anterior capsulorhexis in pediatric white cataracts.

Capsulorhexis↗
PubMedDate not supplied

Combined secondary capsulorhexis and vitreous surgery in a case of anterior capsule contraction and vitreous hemorrhage.

A 59-year-old woman with diabetic vitreous hemorrhage and contracted anterior capsule opening received secondary capsulorhexis and trans pars plana vitrectomy in a single operation. The combined surgery was successful. In addition, the anterior capsule opening was enlarged by the procedure and no further vitreous hemorrhage occurred during the 6 month follow-up period in both eyes. When anterior capsule opening reduction is encountered in patients requiring vitreoretinal surgery, combining secondary capsulorhexis and vitreoretinal surgery together in a single operation maybe provide a good treatment alternative.

Anterior Eye Segment↗
PubMed2002

[Cataract surgery using silicone oil and its elimination via posterior capsulorhexis].

Elimination of silicone oil after a previous vitreoretinal operation is a routine procedure. This procedure is frequently associated with a complicated cataract operation. The standard procedure of oil elimination in one or two stages assumes repeated sclerotomy. Contemporary findings and the authors' experience indicate the risk of the site of sclerotomy. The authors draw attention to a modification of silicone oil elimination while operating the cataract by posterior capsulorhexy which makes it possible to remove the intraocular tamponade without sclerotomy and to implement at the same time peroperative control of the posterior pole. the technique of elimination of silicone via posterior capsulorhexy makes a perfect peroperative check-up of the state of the posterior eye possible it makes it possible to leave the silicone in the eye if it is necessary to prolong the tamponade of the retina it reduces the risk of complications of further sclerotomy it makes reconstruction of the eye by a single operation possible and reduces thus the traumatization of the eye and the patient.

Capsulorhexis↗
PubMed1992

Effect of continuous circular capsulorhexis and intraocular lens fixation on the blood-aqueous barrier.

Permeability across the blood-aqueous barrier to fluorescein was estimated fluorophotometrically in pseudophakic eyes for which a continuous circular capsulorhexis was performed. The permeability index was significantly higher in the in-the-bag fixations than in the out-of-the-bag fixations at 3 and 6 months after surgery, when only bilateral cases were enrolled. Damage to the barrier in eyes with the in-the-bag fixations was attributable to the broad attachment of optics to the anterior capsule, because a positive linear regression was obtained between the permeability index and the doughnut-shaped contact area in eyes with the in-the-bag fixations. The permeability index in eyes with the in-the-bag fixations was as low as that in eyes with the out-of-the-bag fixations when the contact area was small. These results indicate an unfavorable effect of the in-the-bag fixation with broad contact of the optics with the anterior capsule and, thus, suggest either an in-the-bag fixation with a large capsulorhexis or an out-of-the-bag fixation.

Adult↗
PubMed1996

The mechanical properties of the human lens capsule following capsulorhexis or radiofrequency diathermy capsulotomy.

OBJECTIVE: To quantify the biomechanical properties of the capsulotomy edge following continuous-tear circular capsulorhexis (CTCC) or radiofrequency (RF) diathermy capsulotomy. METHODS: A test apparatus was constructed that allowed controlled stretching of capsulotomy edges following CTCC or RF diathermy capsulotomy. The lens contents were removed by phacoemulsification to permit the implantation of probes that exerted a test force on the capsulotomy edge and were moved in diametrically opposite directions using computer-controlled stepping motors. The magnitude of the force was measured during the capsule stretch, which allowed precise determination of the degree of capsular distention at the time of capsular rupture. Selected capsular edges were subsequently examined by scanning electron microscopy. RESULTS: The capsulotomy edge produced by CTCC was significantly stronger (P < .001) than that following RF. The mean (+/-SD) force to achieve capsule rupture was 0.15 +/- 0.06 N with CTCC compared with 0.02 +/- 0.01 N with RF. The mean (+/-SD) increase in the capsulotomy circumference was significantly greater with CTCC at 53% +/- 14.5% compared with RF at 18% +/- 8.5% (P < .001). Scanning electron microscopy disclosed a smooth edge for the CTCC capsulotomy. In contrast, multiple irregularities were seen in the edge following RF. CONCLUSIONS: Continuous-tear circular capsulorhexis provides a stronger capsulotomy and is the preferred method in routine cataract surgery. However, RF diathermy capsulotomy may have a useful role in conditions unfavorable to the safe completion of CTCC.

Biomechanical Phenomena↗
PubMed1992

Capsulorhexis in mature cataracts: why not?

Continuous circular capsulorhexis is now widely used in cataract surgery. In the case of mature cataract, however, this technique may be difficult due to the poor visibility of the anterior capsule. This problem can be overcome performing capsulorhexis under air. A small amount of a high molecular weight viscoelastic agent is injected near the incision, so as to avoid air escaping from the anterior chamber. Visibility is good and the handling of the anterior capsule is easy and safe.

Cataract Extraction↗
PubMed1997

[Scanning electron microscopy studies of the human lens capsule after capsulorhexis].

BACKGROUND: In order to better understand the mechanism of tearing of the human lens capsule during circular capsulorhexis, scanning electron microscopic (SEM) examinations were made particularly of the rhexis edge. MATERIALS AND METHODS: Anterior segments from cornea donor eyes, as well as capsular pieces extracted during cataract surgery, were studied after fixation in glutaraldehyde, critical point drying, and sputtering with gold. RESULTS: The edges of the capsulorhexis were found to be very regular even in the area of zonular attachment. Neither the surface of the lens capsule nor the edge of the rhexis itself indicated any morphological influence on the direction of tearing. CONCLUSION: From the results we conclude that the rhexis of the lens capsule is only directed by the forces applied and not by particular morphological structures. To avoid radial tears, a deep anterior chamber, resulting in a relief of the anterior zonular portion seems most important. This minimizes radial forces on the anterior lens capsule, which provides the best condition for a safe rhexis.

Electrocoagulation↗
PubMed1991

The elastic properties of the lens capsule in capsulorhexis.

We investigated the ability of the anterior lens capsule to stretch and allow removal of lens substance and intraocular lens implantation through a continuous circular capsulorhexis. Capsulorhexis of various sizes (2.5 to 7.5 mm) were performed in 50 eyes obtained post mortem from 31 patients. The nucleus and cortex were removed by either phacoemulsification (35 eyes) or manual extracapsular cataract extraction (15 eyes). The opening of the capsule was then gradually enlarged, using a modified caliper with two pins attached to its tips, until the margins were torn. The capsule was torn when the circumference at the time of rupture was 1.6 times larger than the circumference of the original circular capsulectomy or 5.0 times larger than the diameter of the capsulectomy. Manual extraction of a lens nucleus with profile circumference (sagittal or anteroposterior) of 18.0 to 22.0 mm can be performed through a 5.5-mm opening and a 6.0- to 7.0-mm optic intraocular lens (profile circumference of 13.0 to 17.0 mm) can be implanted through a 4.5-mm capsulectomy.

Aged↗
PubMed1994

Capsulorhexis in the rabbit eye as a model for pediatric capsulectomy.

Continuous curvilinear capsulorhexis (CCC) is now a standard procedure in cataract surgery. In pediatric eyes, however, this technique is difficult to perform. Because of the elasticity and tension of the pediatric anterior lens capsule, the danger of radial tears is high. Similar conditions are found in the rabbit eye. The anterior lens capsule of young albino rabbits is very elastic. We developed a CCC technique in rabbits that allows a controlled round capsular opening. This technique was used in an experimental study with 16 rabbits (32 eyes). Mean capsulorhexis diameter was 4.9 mm +/- 0.9. A radial tear occurred in only two of 32 cases. The technique, which permits a controlled circular anterior capsulectomy for capsules with high surface tension and elastic properties, may be useful in pediatric cases. A clinical trial appears warranted.

Animals↗
PubMed1991

Eccentric capsulorhexis and bidirectional endocapsular phacoemulsification.

The advantages of continuous circular capsulorhexis and endocapsular (endolenticular, posterior chamber, in situ) phacoemulsification are well recognized. Perhaps the only disadvantage of the phacoemulsification technique is the increased operative time. This report presents a new method for endocapsular phacoemulsification which includes a superiorly decentered circular or oval capsulorhexis and more rapid endocapsular phacoemulsification using a combination of one- and two-handed techniques. The procedure may also be safer since most of the phacoemulsification is performed within the central "safe zone" of the posterior chamber.

Cataract Extraction↗
PubMed1993

Progressive constriction of the anterior capsular opening following intact capsulorhexis.

The continuous curvilinear capsulorhexis has rapidly increased in popularity as the procedure of choice when using phacoemulsification for cataract extraction. Only recently, however, have complications of this technique been reported. We review the complications of a continuous curvilinear capsulorhexis and present three cases involving progressive constriction of the postoperative anterior capsular opening. One patient had a history of myotonic muscular dystrophy, another had pars planitis, and the third had high myopia. A review of ocular findings in myotonic dystrophy and pars planitis is also presented, and the possible pathophysiology of this progressive constriction is explored.

Adult↗
PubMed1990

Extracapsular cataract extraction with keyhole capsulorhexis and lens epithelial cell removal.

Circular capsulorhexis with its round continuous anterior capsule opening allows secure fixation of a posterior chamber intraocular lens. The smooth capsular margin edge reduces stress concentration and the risk of radial tears but it makes nucleus delivery in planned extracapsular cataract extraction very difficult. This report describes a technique of small circular capsulorhexis with one relaxing incision that gives a keyhole-shaped capsular opening. A new irrigating capsule retractor for nucleus hydrodissection is also described. This technique is safe and highly reproducible and it allows secure posterior chamber lens fixation.

Cataract Extraction↗
PubMed1992

Refractive effect of capsular bag lens placement with the capsulorhexis technique.

Fifty consecutive patients who had cataract extraction and intraocular lens implantation with a can-opener anterior capsulotomy were compared to 50 patients who had a continuous tear capsulotomy and confirmed capsular bag lens placement. The actual versus the predicted postoperative refraction was calculated with both the SRK II and the Holladay lens power formulas. With both formulas, the capsulorhexis patients required a spectacle correction 0.43 (or 0.44) diopter greater than the can-opener patients when the same A-constant or surgeon factor was used. The recalculated A-constant was 118.23 for the can-opener patients and 118.76 for the capsulorhexis patients; the manufacturer's recommended A-constant was 118.3. The results were statistically significant.

Cataract Extraction↗
PubMed1991

Stretching capacity of capsulorhexis and nucleus delivery.

The stretching capacity of the continuous circular capsulorhexis was studied in 30 human cadaver eyes. The capsulorhexis was found to have a remarkable stretching capacity, allowing safe nucleus delivery in planned extracapsular cataract extraction using hydroexpression. The difficulties encountered when trying to deliver the nucleus by external pressure to the sclera are discussed.

Adult↗
PubMed1990

One-step forceps for capsulorhexis.

There are several popular methods for creating a continuous-tear capsulotomy, or capsulorhexis, which usually involve several instruments and steps. This report describes a new forceps for capsulorhexis that can be used to open the capsule and complete the circular tear in one step. Its unique features are its small size, shortened length, thin, rounded blades with cystotome-type tips for opening the capsule, and round handles for manipulation ease.

Equipment Design↗