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At least 163 records · Page 9Linked to original sources
PubMed1994

Tilt and decentration of bag-fixated intraocular lenses: a comparative study between capsulorhexis and envelope techniques.

Malposition of an intraocular lens (IOL) may cause symptoms such as glare, halos, and other visual aberrations. The purpose of this study is to determine the effect of two different anterior capsulotomy techniques on IOL tilt and decentration. Bag-fixated IOL implantation after uncomplicated extracapsular cataract extraction was performed using both envelope (65 eyes) and continuous circular capsulorhexis (CCC) technique (42 eyes). Eyes were followed-up at least 6 months postoperatively. While the mean IOL decentration after envelope technique was found to be 0.65 mm, this was 0.15 mm after CCC technique. On the other hand, the mean actual tilting angle of IOL after envelope technique was 5.66 degrees, whereas this was 1.13 degrees after CCC technique. The aforementioned differences were statistically significant (p < 0.01, and p < 0.01). Furthermore, in 17 eyes (26.1%) where envelope technique and in 29 (69.0%) eyes where CCC technique was used demonstrated no IOL tilt and decentration. This study shows that the CCC technique may result in less optical problems due to IOL malposition compared to the envelope technique.

Adult↗
PubMed1994

A ring to support the capsular bag after continuous curvilinear capsulorhexis.

We designed four prototypes of a capsular bag supporting ring for supporting and preserving postoperative integrity of the capsular bag, independently of the intraocular lens (IOL) implanted following continuous curvilinear capsulorhexis. An open poly(methyl methacrylate) ring, inserted experimentally in cadaver eyes through a 3.5 mm incision, adjusted well to various capsular bag sizes and could be implanted with common IOL types. Although some capsular shrinkage occurred in vitro, the roundness of the capsular bag equator was preserved, suggesting that the ring may help maintain postoperative capsular bag integrity.

Adult↗
PubMed1993

Phacoemulsification, capsulorhexis, and intraocular lens power prediction accuracy.

Phacoemulsification with capsulorhexis reduces the surgical variability and may result in a more predictable refractive outcome. To evaluate the prediction accuracy with current IOL power prediction formulas, we reviewed a retrospective series of 628 phacoemulsification cases, including 148 short (< 22 mm) and 80 long (> 25 mm) eyes. Using the Binkhorst II formula and the manufacturer's recommended anterior chamber depth (ACD) values, the mean absolute refractive prediction error was 0.56 diopters (D). This error could be reduced to 0.51 D by retrospectively optimizing the ACD values for each lens type. Under similar least error conditions, the mean error was 0.51 D with the SRK/T formula and 0.47 D with the Olsen formula (P < .01). The Binkhorst formula overestimated the refraction in short eyes and underestimated the refraction in long eyes. The SRK/T and the Olsen formula were unbiased with the axial length. We hypothesize that the high prediction accuracy may be partially explained by a more predictable pseudophakic ACD with the current surgical technique.

Anterior Chamber↗
PubMed1993

Postoperative complications of capsulorhexis.

Capsulorhexis has become the preferred method of anterior capsulotomy, and untoward effects have not been frequently noted. Nevertheless, distinct complications of continuous tear anterior capsulotomy are now recognized. These include capsular bag hyperdistention, shrinkage of the anterior capsule opening with visual loss and/or intraocular lens decentration, and lens epithelial cell hyperproliferation on the posterior lens capsule. The latter has not been reported and may be associated wit reduction or closure of laser posterior capsulotomies in the form of a "string of pearls" around the capsule opening. Current styles of capsular surgery and intraocular lens implantation in which the anterior capsule edge overlaps the lens may be responsible for these phenomena. Although altering the surgical methods may obscure these complications, eliminating the anterior subcapsular and equatorial lens epithelial cells is necessary to prevent capsule contraction and lens epithelial cell hyperproliferation.

Cataract Extraction↗
PubMed1992

Mechanics of capsulorhexis.

Continuous (central, circular) curvilinear capsulorhexis (CCC), first introduced by Gimbel and Neuhann, has become increasingly popular, especially for endolenticular phacoemulsification with intracapsular intraocular lens implantation. The principles of simple mechanics are used to facilitate teaching the procedure and to reduce the incidence of complications. A safe and simple method of performing CCC based on these principles is described.

Cataract Extraction↗
PubMed1995

Vacuum capsulorhexis.

A new method of performing continuous curvilinear capsulorhexis is described. It involves the use of a fine point of suction applied to the torn flap of anterior capsule through a fine cannula. This technique offers excellent control of the tear and requires no viscoelastic to maintain the anterior chamber. Only a few inexpensive hand instruments are needed to perform the technique, which is easily learned.

Cataract Extraction↗
PubMed1995

Effect of intraocular lens design on posterior capsule opacification after continuous curvilinear capsulorhexis.

We compared the effect of biconvex and convex-plano (posterior plano) intraocular lenses on posterior capsule opacification (PCO) following continuous curvilinear capsulorhexis (CCC) in 212 eyes. During the three years following surgery, the cumulative frequency of neodymium:YAG laser posterior capsulotomy, calculated with the Kaplan-Meier method, was significantly higher in patients in the biconvex group (32.5% by the third year) than in those in the convex-plano group (5.9% by the third year) (P < .05, Wilcoxon's test; P < .01, Cox-Mantel's test). Measured with the tracing method, the area within a 5 mm diameter central circle that developed Elschnig pearls was 2.93 +/- 4.91 mm2 in the biconvex group and 1.66 +/- 2.37 mm2 in the convex-plano group. In the study, PCO was less severe in the convex-plano group than in the biconvex group following CCC. These results are contrary to those reported previously in patients with can-opener capsulotomy.

Adult↗
PubMed1993

Intraocular lens encapsulation by shrinkage of the capsulorhexis opening.

A 57-year-old man with retinitis pigmentosa and subcapsular cataract had phacoemulsification with a continuous curvilinear capsulorhexis and implantation of a poly(methyl methacrylate) intraocular lens. Six months later, the patient presented with blurred vision and severe anterior capsule fibrosis which led to complete posterior chamber lens encapsulation.

Cataract↗
PubMed1994

Comparison of mechanized anterior capsulectomy and manual continuous capsulorhexis in pediatric eyes.

Performing a continuous curvilinear capsulorhexis (CCC) can be more difficult in children than in adults because the capsular bag is more elastic. In this study we compared two capsulectomy techniques in pediatric eyes: creating a mechanized circular anterior capsulectomy using a vitrector and creating a conventional smooth-edged curvilinear tear or CCC using a forceps or needle. We used 18 pairs of eyes (36 eyes) obtained postmortem from children ranging in age from four days to 16 years. The mechanized vitrector-cut capsulectomy was unsuccessful in only one eye (from a 16-year-old child) in which a radial tear developed. Manual CCC was unsuccessful in six eyes, all from children less than five years of age. We conclude that mechanized circular capsulectomy is not only easier to perform in very young eyes than manual CCC, but it is also safe and creates a capsular opening that resists radial tearing. This mechanized technique gives the surgeon an alternative to use in pediatric eyes in which standard manual CCC may be difficult to perform and control.

Adolescent↗
PubMed1994

Posterior capsulorhexis with optic capture: maintaining a clear visual axis after pediatric cataract surgery.

We describe a technique for preventing secondary membrane formation after pediatric cataract extraction. This technique involves capture of an intraocular lens (IOL) optic through a posterior curvilinear capsulorhexis opening in an attempt to maintain a clear visual axis in children after cataract surgery. This maneuver ensures centration of the posterior chamber IOL because the haptics remain in the capsular bag and the optic is captured in the posterior capsular opening. Also, the need for an anterior vitrectomy may be eliminated. Apposition of the anterior and posterior capsule leaflets anterior to the optic may limit the migration of Elschnig pearls, reducing the incidence of secondary membranes and the need for additional procedures.

Cataract↗
PubMed1990

Nucleus removal following circular capsulorhexis: surface cortex aspiration.

A technique for nucleus removal following circular capsulorhexis is described. After a continuous circular capsulotomy, soft surface cortex surrounding the nucleus is aspirated by an irrigation/aspiration device to separate the nucleus from cortical material and reduce its diameter. With phacoemulsification, the separated nucleus is rotated within the capsular bag and emulsified. With planned extracapsular cataract extraction, the upper nucleus equator is brought out of the capsular bag using an irrigating capsule retractor. The nucleus is then delivered by simple expression or by a Nishi delivery cannula.

Cataract Extraction↗
PubMed1990

Development, advantages, and methods of the continuous circular capsulorhexis technique.

The development of the continuous circular capsulorhexis (CCC) technique has contributed significantly to the safety and effectiveness of cataract extraction and intraocular lens implantation. This technique facilitates every size of smooth, circular, capsular opening, and it produces a strong capsular rim that resists tearing even when stretched during lens material removal or lens implantation. Maintaining the general integrity of the eye and facilitating such procedures as hydrodissection, endolenticular phacoemulsification, capsule polishing, and safe lens implantation in both adults and children are some of the advantages of CCC. This procedure can be performed in several ways, and it has been proven to be consistently reproducible by experienced surgeons.

Cataract Extraction↗
PubMed1989

New disposable cystotome for capsulorhexis.

Circular tear capsulotomy, or capsulorhexis, is becoming an increasingly popular method of anterior capsulotomy. We describe a new cystotome with a simple tip modification which is useful for performing a circular tear capsulotomy. The cystotome is a 27 gauge disposable device that is similar to a conventional cystotome used for a can-opener-type capsulotomy except for its unique but simple tip modification. The beveled tip is first bent at 90 degrees and then twisted on its main axis so that the beveled cutting edge is parallel (i.e., in the same axis) to the shaft of the cystotome. We also briefly describe its method of use.

Cataract Extraction↗
PubMed1996

Capsular opening contraction after continuous curvilinear capsulorhexis and intraocular lens implantation.

PURPOSE: To evaluate the progressive constriction of the anterior capsule opening that can occur after continuous curvilinear capsulorhexis (CCC). SETTING: Kangnam St. Mary's Hospital, Seoul, Korea. METHODS: Changes in the anterior capsule opening after CCC were evaluated in 166 pseudophakic eyes at 1 week and 1 and 3 months postoperatively. The capsular opening diameter was measured with an image analysis system. RESULTS: The capsular opening diameter was reduced by an average of 13.87% 3 months after CCC. There was more dense opacity in the anterior than in the posterior capsule. Lens epithelial cells (LECs) were the main cause of capsule contraction; sex, age, intraocular lens haptic length and haptic material, and CCC size did not have a statistically significant effect on capsule shrinkage (P > .05). Three months after surgery, most eyes with an initial capsular opening diameter of less than 5.5 mm had an opening diameter smaller than 5.0 mm. In most eyes with an initial capsular opening larger than 5.5 mm, the opening remained larger than 5.0 mm. CONCLUSION: Our results suggest that the ideal CCC size is 5.5 to 6.0 mm or larger and that LEC removal is necessary to preserve the pupillary zone and thus prevent progressive capsular opening shrinkage.

Adult↗
PubMed1996

Secondary closure of posterior continuous curvilinear capsulorhexis.

PURPOSE: To examine the hypothesis that removing the center of the posterior capsule would prevent posterior capsular opacification (PCO). SETTING: Department of Ophthalmology, University Hospital Antwerp, Belgium. METHODS: A posterior continuous curvilinear capsulorhexis (CCC) was done before intraocular lens (IOL) implantation in eyes at risk for PCO (uveitic, young adult), retinal detachment after neodymium:YAG (Nd:YAG) laser capsulotomy (highly myopic) or for cystoid macular edema (uveitic, diabetic) and in eyes in which the posterior capsule was opaque intraoperatively. The 51 eyes of 40 patients had a follow-up ranging from 6 months to 2 years. RESULTS: Four eyes (8%) developed partial closure of the posterior CCC without vision impairment; 6 eyes (12%) had total closure, of which 2 (4%) had a loss of two or more Snellen lines necessitating an Nd:YAG laser capsulotomy. CONCLUSION: Young adult eyes and eyes with underlying diabetic retinopathy or uveitis are at risk for total closure of the posterior CCC. Only young adult eyes required Nd:YAG laser capsulotomy after the posterior CCC.

Adult↗
PubMed1996

Forceps for capsulorhexis.

Conventional continuous curvilinear capsulorhexis (CCC) by forceps is connected with use of viscoelastics. A new model of forceps allows CCC without a viscoelastic and has the advantage of a bent-needle cystotome because the terminal part of the instrument is the size of a bent needle. The instrument retains the forceps' ability to grasp tissue firmly and prevents anterior chamber collapse during CCC. I performed the CCC using the new forceps without a viscoelastic in 198 eyes.

Anterior Chamber↗