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Results for “Capsulorhexis”

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At least 469 records · Page 26Linked to original sources

PubMed1999

Cystoid macular edema after phacoemulsification: relationship to blood-aqueous barrier damage and visual acuity.

PURPOSE: To ascertain the incidence of cystoid macular edema (CME) after phacoemulsification and its relationship to blood-aqueous barrier damage and visual acuity. SETTING: A British teaching hospital. METHODS: A prospective trial was performed to document the incidence of CME after routine phacoemulsification with continuous curvilinear capsulorhexis. LogMAR visual acuity and laser flare were measured using the KOWA FC 1000 laser cell-flare meter preoperatively and 1, 14, 30, and 60 days postoperatively. At day 60, a standardized fluorescein angiogram was performed and graded by masked observers. RESULTS: The rate of angiographic CME on day 60 was 19%. Visual acuity at each visit was significantly worse in the CME group (P < .05). The flare and cell values at days 14, 30, and 60 were higher in the CME group at day 60; however, the difference was not statistically significance (P > .05). CONCLUSIONS: The incidence of CME after routine phacoemulsification was 19%. Patients with CME at day 60 had significantly worse visual acuity than those who did not from the first postoperative day throughout the follow-up. There was a trend for patients who had CME at day 60 to have more postoperative inflammation.

Aged↗

PubMed1999

Risk factors for anterior capsule contraction syndrome with polypropylene or poly(methyl methacrylate) haptics.

PURPOSE: To determine the effect of haptic composition on the development of anterior capsule contraction syndrome (CCS) requiring neodymium: YAG anterior capsulotomy. SETTING: Ophthalmology practice in Lancaster, Pennsylvania, USA. METHODS: This retrospective study covered a 30 month period during which 1 surgeon discontinued implanting AMO SI-30NB intraocular lenses (IOLs) with polypropylene haptics (n = 216) in favor of SI-40NB IOLs with poly(methyl methacrylate) (PMMA) haptics (n = 127). The transition was motivated by the suspicion that the PMMA haptics would maintain the capsulorhexis opening better and reduce the need for an anterior capsulotomy. RESULTS: Three eyes with SI-30NB IOLs (1.4%) required anterior capsulotomies; 2 eyes had preoperative pseudoexfoliation syndrome and required the capsulotomy within 3 months of surgery. Three eyes with SI-40NB IOLs (2.4%) required anterior capsulotomies within 4 months; 2 eyes had preoperative pseudoexfoliation syndrome and 1 had traumatic zonular weakness. The incidence of anterior capsulotomy did not differ significantly between the 2 IOL populations (P > .5), although preoperative pseudoexfoliation syndrome was a significant risk factor in both groups (P < .005). CONCLUSIONS: The polypropylene haptics of the SI-30NB IOL and the PMMA haptics of the SI-40NB IOL did not differ significantly in their ability to prevent CCS requiring anterior capsulotomy. Regardless of IOL haptic composition, eyes with preoperative zonular weakness associated with pseudoexfoliation syndrome or ocular trauma can develop CCS within 3 months of surgery and should, therefore, be followed closely in the early postoperative weeks to minimize the sequelae of anterior capsule fibrosis.

Aged↗

PubMed1999

Lens epithelial cell layer formation related to hydrogel foldable intraocular lenses.

PURPOSE: To determine the incidence of postoperative lens epithelial cell (LEC) layer formation anterior to the Hydroview hydrogel foldable intraocular lens (IOL), the effect on vision, and the appearance under scanning electron microscopy (SEM). SETTING: Eye Unit of a district general hospital, Delfzijl, and the Laboratory for Cell Biology and Electron Microscopy, Faculty of Medical Sciences, University of Groningen, The Netherlands. METHODS: In the prospective study, 207 eyes that received a Hydroview hydrogel foldable IOL during 1996 were followed for almost 2 years (range 8 to 98 weeks). Eleven eyes had follow-up of fewer than 8 weeks and were excluded. Some eyes had a transparent to milky-white membrane anterior to the IOL in the plane of capsulorhexis. In the absence of other contributing factors, if best corrected visual acuity was worse than expected, it was assumed to be caused by the membrane. Depending on the membrane's thickness, determined at the slitlamp, patients were offered a neodymium:YAG (Nd:YAG) laser or surgical membranectomy. If surgically excised, the layer was studied by SEM. RESULTS: Of the 196 eyes, 62 eyes (33.16%) developed a thin epithelial cell layer. The membrane appeared a mean of 38.5 weeks postoperatively (range 9.9 to 85.6 weeks). Eleven eyes (5.61%) had visual symptoms varying from low vision to hazy vision or light scatter. Visual symptoms were present even in cases in which the visual axis was not invaded by the membrane. Once this layer was removed surgically or by the Nd:YAG laser, vision improved and symptoms were relieved. Four eyes (2.04%) required a surgical membranectomy. Examination of these removed membranes by SEM showed their multilayer nature and that the LECs had differentiated into fibroblast-like cells with collagenous fibrils and extracellular matrix. CONCLUSIONS: The incidence of LEC membrane formation was higher than expected and increased with time in eyes with a Hydroview IOL. The membrane caused visual symptoms by occluding the visual axis, causing striation on the membrane and the IOL to decenter, tilt, or fold. These symptoms improved after the membrane was removed.

Capsulorhexis↗

PubMed2000

Capsular block syndrome: A case series.

Capsular block syndrome (CBS) or capsular bag distension syndrome has been described after cataract removal with in-the-bag placement of a posterior chamber intraocular lens in the presence of an anterior continuous curvilinear capsulorhexis. Features of CBS include shallowing of the anterior chamber and an unexpected myopic overrefraction; occasionally, there is a persistent uveitis. The patient may be mistakenly diagnosed with pupil block glaucoma or endophthalmitis. We report 9 cases of CBS and their initial diagnoses and management. In 1 case, the capsular bag distention and anterior chamber shallowing are illustrated by ultrasound biomicroscopy.

Adult↗

PubMed2000

Decentration and tilt: silicone multifocal versus acrylic soft intraocular lenses.

PURPOSE: To compare differences in decentration and tilt between a silicone multifocal and an acrylic intraocular lens (IOL) by evaluating postoperative changes. SETTING: Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea. METHODS: Forty eyes of 20 patients with IOL implantation were randomized into 2 groups according to IOL type: 3-piece silicone multifocal IOL or 3-piece acrylic IOL. All lenses were implanted in the capsular bag through a clear corneal incision after continuous curvilinear capsulorhexis and phacoemulsification. The amount of the decentration and the degree of the tilt of each IOL were measured using the EAS-1000 anterior eye segment analysis system 1 day and 1 and 2 months after surgery. RESULTS: No significant difference in decentration and tilt was found among the 3 follow-ups or between lens types. CONCLUSION: Neither IOL decentration nor tilt showed significant progression up to 2 months in eyes with a silicone multifocal or acrylic IOL when the IOLs were placed properly in the capsular bag. The amount of decentration and tilt was similar between lens types.

Acrylic Resins↗

PubMed2000

Decentration, tilt, and near vision of the array multifocal intraocular lens.

PURPOSE: To study the periodic changes in decentration, tilt, and near vision in eyes with the Array(R) multifocal intraocular lens (IOL). SETTING: Department of Ophthalmology, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. METHOD: This study comprised 20 eyes of 10 patients older than 60 years who had binocular cataract and bilateral implantation of the Array multifocal IOL. Mean patient age was 66.0 years (range 60 to 75 years). After a clear corneal incision and continuous curvilinear capsulorhexis were made, each eye had phacoemulsification and in-the-bag IOL implantation. The amount of IOL decentration and degree of tilt were evaluated using the EAS-1000 anterior eye segment analysis system 1 day and 1 and 2 months postoperatively. Near and far visual acuities were measured at the same examinations. RESULTS: No statistically significant differences were observed in decentration (P =.13) or tilt (P =.32) throughout the follow-up. Mean uncorrected distance visual acuity was 0.68 +/- 0.27 (SD), and mean uncorrected near acuity was 0.49 +/- 0.15 2 months postoperatively. Uncorrected distance acuity better than 0.5 was achieved in 14 eyes (77.8%), in which the mean uncorrected distance acuity was 0.80 +/- 0.18 and the mean uncorrected near acuity was 0. 53 +/- 0.14 2 months postoperatively. CONCLUSIONS: Tilt and decentration of the Array multifocal IOL showed no significant progression up to 2 months after implantation. For near acuity, the Array IOL may be an effective aid.

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PubMed1999

Capsular bag distension after optic capture of a sulcus-fixated intraocular lens.

Capsular bag distension from occlusion of the circular anterior capsule opening by the intraocular lens (IOL) optic is a rare complication of capsulorhexis. The nature and source of fluid remain unclear. We report a case of capsular bag distension in an eye with an optic-captured, all-poly(methyl methacrylate), sulcus-fixated IOL. The fluid behind the IOL optic was visible on the first postoperative day and resolved spontaneously by the sixth postoperative week. We believe that retained viscoelastic material in the capsular bag was a major contributor to the fluid.

Aged↗

PubMed1999

A porcine model predicts that a can-opener capsulotomy can be done safely in pediatric patients.

PURPOSE: The purpose of this study was to compare the strength and safety of a continuous circular capsulorhexis (CCC) with a can-opener capsulotomy (COC) in a porcine model that closely resembles the high elasticity of the human pediatric lens capsule. METHODS: COCs (N = 47) and CCCs (N = 102) were performed inside the anterior chamber of fresh pig eyes, and any uncontrolled tears were noted. The circumference of the initial opening was measured in 18 COCs and 13 CCCs. After the opening was stretched to the point of rupture, the circumference was measured again. The ratio of the circumference at rupture to the initial circumference, minus one, was used as a measure of the maximal capsular strain. RESULTS: The can-opener technique produced a smooth round opening. One of the COCs (2.1%) and 23 of the CCCs (22.5%) had uncontrolled tears (chi2, P<.001). The mean maximal strain for COCs was 46.7% (SE, 8.3%) and for the CCCs, 47.7% (SE, 9.9%). This difference was statistically not significant (P = .93 by Student's t test). CONCLUSIONS: The porcine capsule is more reliably opened with fewer uncontrolled tears by a COC than by a CCC. The porcine model predicts that pediatric capsules can be opened safely with a COC.

Animals↗

PubMedDate not supplied

Clinical results of implantation of the Medevec mini-loop haptic anchor plate foldable lenses.

PURPOSE: To evaluate the surgical performance and postoperative outcomes of 50 consecutive implantations of the Medevec VS 2 UV(TM) mini-loop silicone plate lenses. SETTING: Ege University Hospital, Eye Department, Izmir, Turkey. METHODS: Forty-three patients of either sex, aged 49 years, or older, were included in the study. Clear corneal incision, circular curvilinear capsulorhexis, phacoemulsification and implantation of the Medevec VS 2 UV(TM) mini-loop silicone plate lenses using the injector-cartridge system was performed in all cases. The mean outcome measures were ease of implantation, intraoperative and postoperative complications, postoperative centration and visual acuity. RESULTS: The mean follow-up was 10.2 months (range 8-11 months). Twenty-two lenses (44 required two or more manoeuvers). In 6 cases, the lens was implanted into a bag with torn anterior capsule and in 3 patients (6 implanted into the sulcus because of a torn posterior capsule during phacoemulsification). Best corrected visual acuity was > or =7/10 in 48 eyes (96%) and > or =10/10 in 42 eyes (84%) at 8 months. The examination of the lenses after 8 months showed no sign of haze, discoloration or tilt. Mean decentration of the lenses was 0.32 mm +/- 0.19 (SD). There were no cases of cystoid macular edema or retinal detachment. YAG capsulotomy was performed in one eye. CONCLUSIONS: Medevec VS 2 UV(TM) mini-loop silicone plate lenses appeared to have some learning curve for the implantation. They provided -- even in the sulcus -- excellent centration, good visual acuity and minimal postoperative complications.

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PubMed2001

Cataract surgery and transpupillary silicone oil removal through a single scleral tunnel incision under topical anesthesia; sutureless surgery.

The author evaluated the results of combined cataract extraction and transpupillary silicone oil removal through a single scleral tunnel incision, in eyes that had undergone pars plana vitrectomy with silicone oil tamponade. Twenty-four of the 46 eyes were operated on under topical anesthesia with Blumenthal mode mini-nucleus manual extracapsular cataract extraction technique (mini-nuc ECCE), and silicone oil was removed passively through planned posterior capsulorhexis via the scleral tunnel, followed by endocapsular intraocular lens (IOL) implantation. The operation was completed without any suturing. The remaining 22 eyes were similarly operated on with the same cataract extraction technique, but in these cases silicone oil was classically aspirated actively through pars plana sclerotomies. Results were evaluated by visual acuity measurement, duration of operation, and complications. The transpupillary silicone oil removal group had significantly less vitreous hemorrhage (0- 31.8%) and posterior capsule opacification (0-36.4%). Also, the mean duration of the operation was significantly shorter in this group. There was no significant difference between the two groups with regard to postoperative recurrence of retinal detachment (12.5-18.1%) and visual acuity outcome. The combination of mini-nuc ECCE with transpupillary silicone oil removal compares favorably with the combination of silicone oil aspiration through pars plana sclerotomies. This combined technique allows the surgeon to perform the operation under topical anesthesia and no sutures are required. The intervention period is shorter and no posterior capsule opacification or vitreous hemorrhage develops.

Adolescent↗

PubMed1998

Randomized study of the blood-aqueous barrier reaction after phacoemulsification and extracapsular cataract extraction.

PURPOSE: To compare the blood-aqueous barrier (BAB) breakdown after endocapsular phacoemulsification and extracapsular cataract extraction (ECCE). METHODS: Forty-two patients (64-82 years) enrolled for cataract surgery were randomly assigned to phacoemulsification (group I) or ECCE (group II). Patients with pseudoexfoliation syndrome, small pupils, glaucoma, uveitis, dark brown irides, diabetes, treatment with eye drops or anti-inflammatory drugs were excluded. In group I the patients were operated with continuous curvilinear capsulorhexis (CCC), phacoemulsification and implantation of a poly-(methyl methacrylate) (PMMA) intraocular lens (IOL) through a 5.2 mm self-sealing incision. In group II linear capsulotomy, nucleus expression and PMMA IOL implantation through a large incision (10-11 mm) were performed. The incision was sutured. Before surgery and three days and three months after surgery postoperative inflammation and BAB reaction were measured by laser flare photometry and anterior chamber fluorophotometry after intravenous administration of fluorescein. The BAB diffusion coefficient was calculated. Laser flare photometry was performed also after one and two years. RESULTS: According to fluorophotometry, ECCE induced significantly more postoperative BAB breakdown than did phacoemulsification at three days (p=0.00016) and three months (p=0.00829). Laser flare photometry showed more inflammation in the ECCE group than in the phacoemulsification group at three days postoperatively (p=0.00005). CONCLUSIONS: This study suggests that cataract surgery performed with a small, self-sealing incision, CCC and phacoemulsification induces a reduced surgical trauma with less BAB breakdown compared to ECCE using a large sutured incision, linear capsulotomy and nucleus expression.

Aged↗

PubMed1997

Nd:YAG laser clearance of the anterior surface of posterior chamber intraocular lenses.

PURPOSE: To demonstrate the use of Nd:YAG laser in clearing the anterior surface of posterior chamber intraocular lenses. METHOD: Six cases are presented with the following conditions: haemorrhage, inflammatory deposits, a fibrinous papillary membrane, capsulorhexis shrinkage. RESULTS: Nd:YAG laser was successful in managing each of these cases. CONCLUSION: With careful use Nd:YAG laser clearance of the anterior surface of a posterior chamber intraocular lens can be carried out successfully without damaging the lens.

Aged↗

PubMed2001

[Human lens cells in culture. I. Isolation of adult lens epithelial cells from lens capsule preparations and reactivation of nucleus-containing fiber cells].

BACKGROUND: Bovine lens epithelial cells in culture revealed a high sensitivity against micromolar concentrations of linoleic acid. To prove the assumption that unsaturated free fatty acids are risk factors for cataractogenesis, human lens cell lines are needed. Furthermore, the reactivation of nucleus-containing fiber cells to mitotic growth may hint at their role in after cataract genesis. MATERIAL AND METHODS: Epithelium-capsule-preparations obtained by capsulorhexis were cultured in serum containing medium. Subculturing of these adult human lens epithelial cells was done by trypsinization. Fiber cell bundles from the equator region of a fetal human lens were transferred into culture medium. Aggregates of nucleus containing fiber cells were isolated from floating fiber cell bundles by trypsinization. Subculturing and cryoconservation of suitable cell lines. RESULTS: Primary culture of epithelium-capsule-preparations results in flattening, migration and proliferation of adult human lens epithelial cells. Nucleus containing fiber cells were reactivated to mitotic growth after adhesion to a suitable substratum. Established cell lines were received from adult human lens epithelial cells and fetal human fiber cells after repeated subculturing. CONCLUSIONS: Lens-capsule-preparations available from cataract surgery are well suited for the isolation of human lens cell lines, which were needed for testing cytotoxicity of drugs and for tracing of cataractogenic risk factors. The finding that nucleus containing fiber cells from the equator of human lenses can be reactivated to proliferating cells let us suppose, that these cells, which can not be removed easily from the posterior lens capsule, contribute to the after cataract formation.

Adult↗

PubMed2004

Comparing phacoemulsification and extracapsular cataract extraction in eyes with pseudoexfoliation syndrome, small pupil, and phacodonesis.

BACKGROUND: This study aims to compare the frequency of intraoperative and postoperative complications between the modern phacoemulsification technique and the extracapsular cataract extraction technique in patients with pseudoexfoliation syndrome. PATIENTS AND METHODS: A prospective randomized study comprised 94 eyes with cataract, pseudoexfoliation syndrome, small pupil and slight to moderate phacodonesis. These eyes were randomly assigned into two groups. In the first group all patients (47 eyes) were operated on using a standard phacoemulsification technique (iris hooks, anterior capsule staining and capsular tension ring after capsulorhexis), while in the second group all patients (47 eyes) underwent a classic extracapsular cataract extraction. The main outcome measures were the frequency of intraoperative zonular tears, capsular rupture, vitreous loss and corneal edema, as well as the best-corrected visual acuity. RESULTS: Intraoperative zonular separation was recorded in one eye (2.1 %) and in 15 eyes (31.9 %) for the first and second groups, respectively (P < 0.001). Posterior capsule rupture with or without zonular separation occurred in two eyes (4.2 %) of the first group and in eight eyes (17.0 %) of the second group (P < 0.05). Vitreous loss also had a higher rate in the second group (17.0 % versus 4.2 %, P < 0.05). The postoperative difference in best-corrected visual acuity was also significant between the two groups, being higher in patients operated on using phacoemulsification technique (P < 0.001). CONCLUSIONS: In the difficult cases of cataract associated with pseudoexfoliation syndrome, small pupil and phacodonesis, the modern small-incision cataract surgery provides better results with a low rate of intraoperative and postoperative complications when compared with the extracapsular cataract extraction technique.

Aged↗

PubMed2004

[Capsular bag distention after implantation of foldable acrylic lenses].

BACKGROUND: Incomplete removal of the viscoelastic material during cataract surgery may lead to the early postoperative capsular block syndrome. In this retrospective case series, postoperative capsular bag distention after implantation of a foldable acrylic lens is reported and the sequelae are analyzed. PATIENTS AND METHOD: In a retrospective case series, 10 eyes of altogether 1674 eyes that underwent cataract surgery in the years 2001 and 2002 were identified with early postoperative capsular block syndrome. All 10 eyes had cataract removal with continuous curvilinear capsulorhexis, phacoemulsification and a foldable acrylic lens was placed in the capsular bag. In 4 of 10 eyes cataract extraction was combined with trabeculectomy. All patients had posterior Nd:YAG capsulotomy. Refraction was performed before and after capsulotomy. RESULTS: Postoperative examination showed capsular bag distention in all eyes. The mean postoperative spherical equivalent was -3.9 +/- 1.6 Dpt. As the target refraction was -1.2 +/- 1.0 Dpt there was an average of -2.7 +/- 1.4 Dpt of induced myopia. A mild increase in postoperative anterior chamber inflammation was noted only in 1 patient and shallowing of the anterior chamber was observed in another patient. Posterior Nd:YAG capsulotomy was performed 4.5 +/- 4.3 months after surgery. The mean refractive shift after Nd:YAG capsulotomy was 1.9 +/- 1.9 Dpt. CONCLUSIONS: Unexpected postoperative myopic correction was the main manifestation of capsular block syndrome in this series. Intraoperative use of miotics prohibiting optical control of complete viscoelastic removal may explain the high proportion of combined procedures. In the case of unexpected postoperative myopia the position of the intraocular lens within the bag should be checked and attention should be paid to possibly incompletely removed viscoelastic material.

Acrylates↗

PubMed2004

Complete occlusion of the anterior capsular opening by fibrocellular membrane associated with retained silicone oil: a clinicopathologic correlation.

BACKGROUND: To report the clinicopathologic features of a fibrocellular membrane in a pseudophakic eye with retained silicone oil in the absence of any capsular contraction syndrome, necessitating repeat anterior capsulorhexis. METHODS: Clinicopathologic report of a case. RESULTS: Histopathologic study of the membrane showed absence of any true periodic acid Schiff-positive capsule within the specimen. Clinically, there was no evidence of any anterior capsular contraction. The fibrocellular membrane may have occurred as a result of inflammatory and mechanical effects of silicone oil in the anterior chamber or as a result of the intraocular lens design. CONCLUSION: The authors report the clinicopathologic features of a fibrocellular membrane occluding the anterior capsular opening in a pseudophakic eye with retained silicone oil, in the absence of any capsular contraction. The stimulus for its formation may have been the inflammatory and mechanical effects of retained silicone oil in the anterior chamber.

Adult↗

PubMed1999

Capsular opacification after cataract surgery.

Posterior-capsule opacification, by far the most common complication of primary cataract surgery, continues to stimulate important work toward understanding its causes, preventing it, and effectively treating it. Of special note here are a report by Koch and Kohnen that a combination of vitrectomy and posterior capsulorhexis is required to inhibit posterior-capsule opacification in pediatric patients; work by Nishi et al. toward the dream of replacing the cataractous lens with a flexible artificial lens, supported by the natural capsular bag; and methods by Tetz et al. and Pande et al. for precise quantification of posterior-capsule opacification.

Animals↗

PubMed2006

Implantation of single-piece foldable acrylic IOLs in small children in the Ukraine.

PURPOSE: To evaluate the efficacy and outcome of implantation of a single-piece foldable acrylic intraocular lens (IOL) in children younger than 2 years in the Ukraine. METHODS: A total of 31 children from all over the Ukraine with a median age of 11 months (range 2-28 months) underwent cataract surgery with anterior and posterior capsulorhexis, implantation of a single-piece AcrySof SA30AL IOL and anterior dry vitrectomy. Of these, 22 patients attended the last follow-up. Ten patients had follow-up periods of 12 months; 12 had follow-up periods of 18 months. At the postoperative visits, we investigated visual acuity (VA), whether or not the subject had strabismus, lens epithelial cell migration and signs of secondary glaucoma. RESULTS: The single-piece IOL remained clinically centred in all eyes. No secondary glaucoma was detected. Eleven patients needed surgery for after-cataract. All but two patients achieved better VA after surgery. Many patients suffered from deprivation amblyopia as quite a few cataracts were probably congenital; however, the improvement in VA shows that cataract surgery was worth performing despite the late intervention. CONCLUSION: The foldable single-piece acrylic IOL seems to be well tolerated by children aged 0-2 years. No serious complications were seen and no patient developed secondary glaucoma within the follow-up time. However, lens epithelial cells are very lively in this age group.

Acrylic Resins↗