SEARCH · PubMed Health

Results for “Capsulorhexis”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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

At least 541 records · Page 30Linked to original sources

PubMed2002

Capsular block syndrome associated with horizontal jerk nystagmus.

A 78-year-old cataract patient with horizontal jerk nystagmus had phacoemulsification and intraocular lens (IOL) implantation in the capsular bag with continuous curvilinear capsulorhexis. One week postoperatively, the posterior capsule ballooned posteriorly, the anterior capsule opening was sealed to the IOL optic, and a transparent liquefied substance accumulated between the lens optic and the posterior capsule. The best corrected visual acuity was 0.6 with a myopic shift compared with the refraction after the first day. A neodymium:YAG laser posterior capsulotomy was performed, and the capsular block syndrome (CBS) resolved. The results confirm the experimental model proposed by Zacharias suggesting that saccadic eye movements contribute to CBS under certain anatomic conditions.

Aged↗

PubMed2001

Prosthetic iris implantation for congenital, traumatic, or functional iris deficiencies.

PURPOSE: To determine the efficacy and safety of surgical implantation of prosthetic iris devices in patients with anatomic or functional iris deficiencies. SETTING: Cincinnati Eye Institute, Cincinnati, Ohio, USA. METHODS: Twenty-five patients were enrolled in an interventional prospective noncomparative case series. Twenty-eight eyes had prosthetic iris diaphragm implantation for traumatic iris defects, congenital aniridia or iris coloboma, herpetic iris atrophy, surgical iris loss, or ocular albinism. Prosthetic iris implantation was performed with phacoemulsification and intraocular lens (IOL) implantation in 20 eyes, secondary IOL implantation in 6 eyes, and IOL exchange in 1 eye. A single pseudophakic eye with disabling glare secondary to traumatic aniridia had secondary prosthetic iris implantation alone. The surgical ease of insertion, intraoperative and postoperative complications, postoperative anatomic results, visual acuity, and subjective glare reduction were evaluated. RESULTS: Patients were followed postoperatively for a mean of 10.2 months (range 1.4 to 25.7 months). All eyes achieved the desired anatomic result. Visual acuity was improved in 22 of 28 eyes (79%), unchanged in 5 eyes, and worsened by a single line in 1 eye. Patients were surveyed postoperatively to determine the change in glare disability. The severity of glare disability was subjectively improved in 23 of 24 patients (96%) who responded to the survey. Intraoperative complications included 3 fractured implants as well as an incomplete or torn capsulorhexis in 3 eyes. Postoperative complications included transient hypotony in 2 eyes, mild persistent inflammation in 1 eye, and macular edema followed by a retinal detachment in 1 eye with recent severe trauma. CONCLUSIONS: Implantation of prosthetic iris devices improved postoperative outcomes by reducing glare disability and, in selected cases, by correcting aphakia. Although operating on traumatized, congenitally aniridic, or uveitic eyes presents special challenges, implantation of prosthetic iris devices appears to be a safe and effective method for reducing the ubiquitous glare in patients with iris deficiency.

Adult↗

PubMed2002

Biocompatibility of hydrophilic intraocular lenses.

PURPOSE: To assess the biocompatibility of 3 hydrophilic acrylic intraocular lenses (IOLs) by evaluating the postoperative cell reaction on the IOL surface, anterior capsule opacification (ACO) rate, and presence of membrane growth over the anterior IOL surface. SETTING: University Eye Clinic of Trieste, Trieste, Italy. METHODS: In this prospective study, 73 patients were randomized to receive 1 of 3 types of hydrogel IOLs after phacoemulsification: Storz Hydroview H60M, Corneal ACR6D, or Ioltech Stabibag. To analyze and photograph the anterior IOL surface, slitlamp biomicroscopy and specular microscopy were performed 7, 30, 90, and 180 days after surgery. Small, epithelioid, and giant inflammatory cell reaction was evaluated. In addition, ACO and membrane growth on the anterior IOL surface were assessed. RESULTS: Low inflammatory cell adhesion was observed on the anterior surface of all 3 IOLs. The Stabibag group had a significantly higher grade of small inflammatory cell reaction 7 and 30 days after surgery. A significantly higher rate of ACO was observed in the ACR6D group. The Hydroview and ACR6D groups had a significantly higher percentage of membrane growth from the capsulorhexis edge onto the anterior IOL surface than the Stabibag group. CONCLUSIONS: Clinically, the 3 hydrophilic IOLs behaved in a different manner, showing the different forms of biocompatibility. Results indicate that a different chemical composition determines correspondingly different protein absorption on IOL surfaces. This might result in a different adhesion pattern and spreading of lens epithelial and inflammatory cells.

Acrylic Resins↗

PubMed2002

Cortical removal simplified by J-cannula irrigation.

Subincisional cortical removal is one of the more specific obstacles impeding the performance of uneventful cataract extraction. In this technique, staged use of a J-cannula irrigates the cortex remaining after phacoemulsification, particularly in the subincisional space. This is followed by standard automated aspiration. The irrigation procedure is independent of a small pupil or capsulorhexis and typically allows for complete cortical cleanup in less than 1 minute. The details of the procedure, used in more than 3000 cases, are reported.

Humans↗

PubMed2002

Pupillary capture after combined management of cataract and vitreoretinal pathology.

PURPOSE: To report the incidence, pathogenesis, and management of pupillary capture after combined phacoemulsification with intraocular lens (IOL) implantation and vitreoretinal surgery. SETTING: Oxford Eye Hospital, The Radcliffe Infirmary, Oxford, United Kingdom. METHODS: This retrospective case review comprised 12 patients who developed pupillary capture after combined phacoemulsification, IOL implantation, and pars plana vitrectomy (PPV). Eleven IOLs were implanted in the capsular bag, and 1 was sulcus fixated. All patients had a long-acting gas tamponade and were advised to lie face down postoperatively. All patients subsequently had IOL repositioning using a bimanual technique. RESULTS: The incidence of pupillary capture was 8.95% and occurred a mean of 3.25 weeks postoperatively. At least 6 clock hours of the pupillary margin were captured by the optic except in 1 case in which the pupillary capture was total. Half the patients had posterior capsule opacification that required a neodymium:YAG laser capsulotomy after IOL repositioning. CONCLUSIONS: The incidence of pupillary capture after combined phacoemulsification, IOL implantation, PPV, and injection of long-acting gas was high. This complication can be minimized by creating a smaller capsulorhexis, having the patient maintain a strict face-down position, securing wound closure, and injecting an air bubble into the air chamber to push the iris-lens diaphragm posteriorly.

Adolescent↗

PubMed2002

Primary repair and intraocular lens implantation after perforating eye injury.

PURPOSE: To evaluate the clinical outcome after primary treatment of lens injuries with corneal or corneoscleral trauma. METHODS: Ten eyes of 10 patients were retrospectively evaluated. There were no foreign bodies in any eye. After primary repair, an anterior chamber maintainer (ACM) was introduced through the inferotemporal corneal quadrant. Sodium hyaluronate 1.4% (Healon GV(R)) was injected, and the anterior capsule was stained with trypan blue 0.1% vital stain (Vision Blue) under the viscoelastic substance. After a capsulorhexis was created, the lens material was aspirated. The nucleus was delivered from the scleral tunnel, which was opened from the superior/superotemporal corneal quadrant. A conventional 21.0 diopter poly(methyl methacrylate) intraocular lens (IOL) with a 5.5 mm optic and overall diameter of 12.5 mm (Dr. Schmidth(R), Hannan Kibbutz) was implanted through the scleral tunnel. The scleral tunnel was not sutured, and the corneal entry sites were closed with stromal hydration. RESULTS: The final best spectacle-corrected visual acuity (BSCVA) was better than 20/100 in all patients, and 6 patients had a BSCVA of 20/20. The IOL was in the capsular bag in all patients at the last follow-up. The mean follow-up was 12.3 months (range 7 to 25 months). The main visually limiting factors were corneal scar, irregular astigmatism, and traumatic maculopathy. CONCLUSIONS: Primary IOL implantation in carefully selected patients with penetrating corneoscleral lens injury may yield visually rewarding results. The use of a vital stain to increase the visibility of the injured anterior capsule and of a closed scleral tunnel system with an ACM increased the surgical safety.

Adolescent↗

PubMed2002

Changes in the area of the anterior capsule opening after intraocular lens implantation.

PURPOSE: To evaluate the reduction rate of the area of the anterior capsule opening after continuous curvilinear capsulorhexis (CCC) with 3 types of intraocular lenses (IOLs). SETTING: St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. METHODS: Sixty-five eyes of 51 patients having phacoemulsification and IOL implantation were assigned to 1 of 3 groups based on type of IOL: 1-piece acrylic (n = 16), 3-piece acrylic (n = 26), or silicone (n = 23). The area of the anterior capsule opening was measured 1 day and 1, 2, 3, 6, and 12 months postoperatively. RESULTS: There was significant reduction in the area of the anterior capsule opening 1 day to 3 months postoperatively in all 3 groups (P <.001). There was no further reduction after 3 months in any group. The reduction in the area of the anterior capsule opening was significantly less in both acrylic IOL groups than in the silicone IOL group at 3 months (P =.040) and 12 months (P =.023); however, there was no significant difference between the 2 types of acrylic IOLs (P =.933). CONCLUSIONS: Although there was a reduction in the area of the anterior capsule opening in all patients, the amount was significantly less in the 2 acrylic IOL groups than in the silicone IOL group. This should be considered when selecting an IOL, especially for eyes at risk for capsule contraction.

Acrylates↗

PubMed2003

Scheimpflug photography study of ophthalmic viscosurgical devices during simulated cataract surgery.

PURPOSE: To evaluate by Scheimpflug photography the capacity of several commercially available ophthalmic viscosurgical devices (OVDs) to remain in the anterior chamber and maintain anterior chamber depth (ACD) during simulated cataract surgery in porcine cadaver eyes. SETTING: Department of Preclinical Ophthalmology, Pharmacia & Upjohn AB, Uppsala, Sweden. METHODS: Eighty eyes from newly slaughtered pigs were used. They were distributed equally among 8 OVDs: Amvisc Plus (sodium hyaluronate 1.6%), Biolon (sodium hyaluronate 1.0%), Biolon Prime (sodium hyaluronate 1.2%), Healon (sodium hyaluronate 1.0%), Healon GV (sodium hyaluronate 1.4%), Healon5 (sodium hyaluronate 2.3%), Provisc (sodium hyaluronate 1.0%), and Viscoat (sodium hyaluronate 3.0%-chondroitin sulfate 4.0%). Scheimpflug photographs were taken using a Nidek EAS-1000 instrument before surgery (control), after injection of the OVD, after continuous curvilinear capsulorhexis (CCC), and after lens extraction by phacoemulsification. Differences in the ACD with a P value less than 0.05 were considered statistically significant. The retention capacity was visually assessed. RESULTS: Healon5 had a significantly higher capacity to maintain the ACD than the other OVDs after CCC and phacoemulsification. After injection, Healon5, Viscoat, and Biolon Prime showed similar ACD-maintaining capacities. CONCLUSIONS: The capacity of Healon5 to maintain the ACD during cataract surgery, ie, neutralizing the vitreous pressure and stabilizing the anterior segment of the eye, was significantly higher than that of the other OVDs.

Animals↗

PubMed2003

Iridectomy of the anterior iris stroma using the vitreocutter during phacoemulsification in patients with iridoschisis.

We present a technique to manage iridoschisis. This technique for anterior iridectomy of the affected iris fibers avoids intraoperative obstruction of the phaco tip and prevents postoperative complications such as corneal decompensation and glaucoma. Before the capsulorhexis is created, a vitreocutter is inserted in the anterior chamber and used to cut the iris strands at the site of the iridoschisis, making an anterior sectorial stromal iridectomy and preserving the iris pigment epithelium. Phacoemulsification is then performed. After the pupil is constricted with carbacol, remnants of the loose anterior iris fibers are excised with the vitreocutter and the scleral incision is sutured.

Aged↗

PubMed2004

Diagnosis and management of congenital cataract with preexisting posterior capsule defect.

PURPOSE: To establish and evaluate the diagnostic signs, intraoperative performance, and postoperative outcomes in children with congenital cataract with a preexisting posterior capsule defect (PCD). SETTING: Iladevi Cataract & IOL Research Centre, Ahmedabad, India. METHODS: This study evaluated 400 consecutive eyes that had congenital cataract surgery, of which 27 (20 children) had a confirmed preexisting PCD. Seven children had bilateral defects. The preoperative diagnostic signs of PCD under maximum pupil dilation included well-demarcated, thick defect margins; white dots on the posterior capsule; and white dots in the anterior vitreous that moved with the degenerated vitreous like a fish tail (fish-tail sign). Hydrodissection was not attempted. Bimanual irrigation/aspiration and 2-port anterior vitrectomy were performed. The mean follow-up was 17.9 months +/- 16.96 (SD). RESULTS: The mean age of the 16 boys and 4 girls with a PCD was 21.98 +/- 33.33 months. Nineteen eyes (70.3%) had total white mature cataract. In 7 eyes (25.92%), the preexisting PCD was converted into a posterior capsulorhexis. Twenty eyes (74.07%) had an AcrySof MA30BA intraocular lens (IOL) implanted in the bag and 4 eyes (14.81%), in the sulcus. Three eyes (11.11%) were left aphakic. The visual axis remained clear in all eyes, and the IOL was well centered in 24 eyes (88.88%). CONCLUSION: Establishing the diagnostic signs of PCD with the eye fully dilated and carefully planning the surgery produced satisfactory technical and visual outcomes.

Cataract↗

PubMed2004

Clinical comparison of Healon5 and Healon in phacoemulsification and intraocular lens implantation; Randomized multicenter study.

PURPOSE: To compare the overall clinical performance during phacoemulsification and intraocular lens (IOL) implantation, the effect on intraocular pressure (IOP), and the effect on corneal endothelium of Healon5 (sodium hyaluronate 2.3%) and Healon (sodium hyaluronate 1.0%) ophthalmic viscosurgical devices (OVDs). SETTING: Multicenter study. METHODS: In this randomized prospective clinical study, the performance of Healon5 (viscoadaptive; dispersive and cohesive) and Healon (cohesive) during cataract surgery was evaluated in 157 patients, 79 with Healon5 and 78 with Healon. Surgeons evaluated the following on a 5-point scale: retention during phacoemulsification (primary endpoint), ease of injection, anterior chamber maintenance during continuous curvilinear capsulorhexis (CCC), facilitation of IOL implantation, and ease of removal from the eye. Masked examiners other than the surgeon performed the following measurements: IOP preoperatively and 5 and 24 hours, 7 days, and 3 months postoperatively; corneal thickness before and 24 hours, 7 days, and 3 months postoperatively; and corneal endothelial cell count preoperatively and 3 months postoperatively. RESULTS: Intraocular retention during phacoemulsification was assessed as good or very good in 77% in the Healon5 group and 8% in the Healon group; the difference was statistically significant (P<.0001, Wilcoxon rank sum test). The Healon5 group had significantly better scores for anterior chamber maintenance during CCC (P<.0001) and facilitation of IOL implantation (P =.032), and the Healon group had significantly better scores for ease of injection (P<.0001) and ease of removal (P<.0001). There were no statistically significant between-group differences in IOP, corneal endothelial cell count, or corneal thickness. CONCLUSIONS: Surgeons rated Healon5 better than Healon in retention during phacoemulsification, anterior chamber maintenance during CCC, and facilitation of IOL implantation. They assessed Healon as easier to inject and remove. There was no difference in safety-related parameters between the 2 OVDs. These findings indicate that Healon5 is effective in cataract surgery.

Aged↗

PubMed1993

Unwanted optical images with narrow profile intraocular lenses compared with conventional intraocular lenses.

About 35% of intraocular lenses now implanted in the United States are narrow profile lenses, measuring on the average 5.0 mm by 6.0 mm. This study sought to determine whether these lenses cause unwanted optical images with a decrease in the quality of vision. Seventy-five eyes with a 5.0 mm x 6.0 mm intraocular lens (IOL) were compared with 75 eyes with a 6.5 mm IOL. All patients had capsulorhexis, phacoemulsification, and capsular fixation of the IOL. There was no statistically significant difference in unwanted visual images (16% and 20%, respectively), ability to drive at night (79% and 69%), or patient satisfaction. Careful patient selection is, however, important.

Aged↗

PubMed1992

Effect of posterior chamber intraocular lens design and surgical placement on postoperative outcome.

Intraocular lens (IOL) design, optical configuration, and placement have potential effects on postoperative outcome. Laboratory studies have suggested that one-piece, biconvex designs may reduce or delay posterior capsular opacification and that in-the-bag fixation of the posterior chamber IOL may reduce inflammation. To document the clinical significance of IOL design and placement, we conducted a randomized, prospective, clinical trial. Six hundred uncomplicated capsulorhexis and phacoemulsification patients were randomized in a three-factor design to receive an IOL that was one-piece or three-piece, had a biconvex, plano-convex, or laser ridge optic, and was bag-or sulcus-fixated. Treatment differences were related to lens placement. Patients with bag-fixated IOLs had less posterior capsular opacification, fewer YAG laser capsulotomies, a higher percentage of centered lenses, less inflammation, and fewer late posterior capsular striae than those with sulcus-fixated IOLs. In the latter group, patients with three-piece IOLs had fewer posterior capsular striae at three months postoperatively. All six occurrences of haptic loop distortion were in patients with three-piece IOLs. Patients with the one-piece design had less late inflammation than those with the three-piece design. Fewer YAG capsulotomies were necessary at one year in patients with the biconvex design than in those with the plano-convex or laser ridge configurations. Operative complications, endothelial cell loss, and postoperative complications were not IOL-related.

Adult↗

PubMed1992

Incidence of retinal detachment following Nd:YAG capsulotomy after cataract surgery.

In a retrospective study, we reviewed 218 consecutive Nd:YAG laser posterior capsulotomies performed at the Gimbel Eye Centre between June 1987 and November 1989 for the incidence of retinal detachment (RD) following treatment. Matched controls were found for 198 YAG cases. The median post-surgical follow-up for the YAG cases was 49.5 months; for the controls, 50.0 months. The median time between cataract extraction and YAG laser posterior capsulotomy was 24.8 months. The median follow-up after YAG was 24.2 months. Two of the 198 YAG cases (1.0%) and one of the 198 controls (0.5%) had RD. In the YAG cases, RD occurred 54.8 and 36.5 months after cataract surgery; in the control cases, 51.8 months after cataract surgery. Retinal detachment occurred at 15.0 and 17.0 months after YAG capsulotomy. These rates were lower than those reported in the literature. We feel that the surgical techniques of continuous circular capsulorhexis and in-the-bag IOL placement reduce the risk of RD following Nd:YAG posterior capsulotomy.

Aged↗

PubMed1995

Keratolenticuloplasty: arcuate keratotomy for cataract surgery and astigmatism.

Cataract surgery has evolved into a procedure in which pre-existing refractive errors can be corrected simultaneously to improve uncorrected visual acuity following surgery. This paper describes keratolenticuloplasty, a new technique of clear corneal arcuate keratotomy for cataract surgery that corrects pre-existing astigmatic errors at the time of cataract extraction. This technique uses topical anesthesia, a single pair of arcuate corneal incisions placed on the steepest axis of astigmatism, one-step capsulorhexis, hydrodissection, intercapsular phacoemulsification, and injection of an elastic intraocular lens within the capsular bag. The technique has been used in over 1,000 patients with follow-up of 24 months. Uncorrected visual acuity of 20/40 or better with no associated complications was achieved in 96% of patients.

Anesthesia, Local↗

PubMed1994

Biomechanical aspects of the anterior capsulotomy.

We used the finite element method to evaluate different capsulotomy techniques. Nucleus expression was simulated in a computer model to visualize stress distribution in the anterior capsule. The finite element model demonstrated that the capsulorhexis edge is strong because of low and uniform stress distribution in the tissue. With can-opener and envelope capsulotomies, areas of high stress accumulation create the risk of tears during surgery.

Cataract Extraction↗

PubMed1995

Complications of silicone disc intraocular lenses.

Through a 4.5 mm corneoscleral incision, we implanted one of two types of foldable, silicone disc, posterior chamber intraocular lenses (IOLs) in the bag in 35 eyes of 32 patients after phacoemulsification and capsulorhexis. Five lenses were explanted in the early postoperative period because of complications. We followed 24 eyes for an average of 38 months. At the end of follow-up, 5 of the lenses had decentered by 1 mm; 8 (33%) had developed clinically significant posterior capsule opacification (PCO). We believe the IOLs' disc shape may not allow firm fixation, resulting in opacification. On average, there were no significant differences in long-term results between the two silicone disc lens types.

Aged↗

PubMed1991

Lens anatomical principles and their technical implications in cataract surgery. Part I: The lens capsule.

Optimal fixation and position of an intraocular lens (IOL) is achieved when it is located in the capsular bag. A peripheral tear from the central opening to the lens periphery is associated with a high incidence of dislocation of at least one loop from within the capsular bag and lens decentration. A central round continuous capsulectomy (capsulorhexis), within the zonule-free area, provides long-term and balanced IOL fixation. To perform a well-controlled capsulectomy, a deep and stable anterior chamber should be maintained throughout the surgery. This is achieved by using a continuous anterior chamber maintainer that regulates the pressure in the anterior chamber. This paper reviews the clinical anatomical guidelines of the lens capsule and the anterior chamber and presents the authors' preferred technique for optimal anterior capsulectomy.

Anterior Chamber↗