PubMed · 15652039
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David Allen. 2004. Cataract.. https://pubmed.ncbi.nlm.nih.gov/15652039/
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BACKGROUND: Capsule related complications are common following pediatric cataract surgery. We report a new technique of multiple anterior capsulorhexisotomies after lens aspiration and intraocular lens (IOL) implantation. METHODS: After performing automated lens aspiration, an IOL was implanted into the capsular bag. A bent 26 gauge needle was introduced through one side port and multiple small cuts were made in one half of the circumference of the anterior capsular rim by making a radial movement of the needle tip centripetally over the margin of the anterior capsular rim. The needle was again introduced through the other side port and multiple similar cuts were made in the other half thereby creating nearly 20 - 30 cuts at the margin of the anterior capsular rim. RESULTS: The mean size of the primary capsulorhexis was 4.33 +/- 0.20 mm. A uniform enlargement of the capsulorhexis could be performed in all the eyes without peripheral extension in any of the eyes. There was no damage to the posterior capsule and no scratch mark on the IOL. In one eye, the primary capsulorhexis was slightly eccentric, though it was covering the IOL optic all around. The rhexisotomies in this eye were limited to the capsular rim that was overlapping more on the IOL optic (sectoral anterior capsulorhexisotomies). CONCLUSION: The technique of postage stamp anterior capsulorhexisotomies is a feasible technique in pediatric cataracts.
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PURPOSE: To evaluate the safety of trypan blue 1% and indocyanine green (ICG) 0.5% in assisting visualization of anterior capsule during phacoemulsification in mature cataract. SETTING: Department of Ophthalmology, United Christian Hospital, Hong Kong, China. METHODS: This prospective randomized clinical trial comprised 46 eyes with mature cataract receiving phacoemulsification and posterior chamber intraocular lens implantation. They were randomized into 3 groups (trypan blue, ICG, and control without stain). Visual acuity, endothelial cell count, corneal clarity, anterior chamber reaction, and intraocular pressure (IOP) were documented before surgery and 1 week, 1 month, and 3 months postoperatively. The absolute phaco time was also recorded. RESULTS: There was no significant difference in absolute phaco time (P=.17), mean endothelial cell loss (P=.72 at 1 week, P=.43 at 1 month, and P=.60 at 3 months) and no significant correlation between the absolute phaco time and the change in endothelial cell count (P=.50 at 1 week, P=.10 at 1 month, and P=.60 at 3 months) in the 3 groups. None of the patients had postoperative IOP greater than 21 mm Hg. All eyes had clear corneas and a quiet anterior chamber 3 months after surgery. CONCLUSION: Both trypan blue 1% and ICG 0.5% are safe for assisting visualization of the anterior capsule during phacoemulsification of mature cataract.