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 631 records · Page 35Linked to original sources

PubMed2001

Proliferation of lens epithelial cells on the Acrysof intraocular lens: clinical and histological features of a case.

Postoperative deposits on the surface of intraocular lenses (IOLs) have been demonstrated in vivo for many IOL material types. The Acrysof acrylic lens develops a granular material extending from the capsulorhexis margin onto the IOL's anterior surface during the first 4 weeks after surgery in a significant proportion of cases. Complete resolution of this membrane occurs by 3 months in almost all cases. The case is presented of an 81-year-old woman who had a persisting membrane coverng the IOL surface at 6 months. This membrane was removed surgically and pathology showed the constituent cells to be of lens epithelial cell origin.

Acrylic Resins↗

PubMed2001

[Influence of surgery-related factors on the Nd:YAG laser capsulotomy rates of 3-piece silicone IOLs - analysis of 457 pseudophakic human globes obtained post mortem].

BACKGROUND: The purpose of this study was to analyze any possible surgical reasons which may have had caused posterior capsule opacification in 3-piece silicone IOLs that had required Nd:YAG laser treatment. Special attention was given to 1) quality of cortical clean up, 2) type of haptic fixation, and 3) continuous curvilinear capsulorhexis (CCC) size and shape. MATERIALS AND METHODS: Human eyes obtained post-mortem implanted with 3-piece silicone optic - PMMA haptic (SI 40 NB) and 3-piece silicone optic - Prolene haptic (SI 30 NB) designs IOLs, accessioned between January 1993 and December 2000 were evaluated by gross examination from behind under an operating microscope using the Miyake-Apple posterior photographic technique. The area and intensity of Soemmerring's ring and type of fixation was studied in 457 eyes. The mean diameter of the CCC and relation of the CCC edge to the optic rim were analyzed in 221 eyes. RESULTS: 1) The amount of Soemmerring's ring formation was significantly larger in the group of IOLs requiring Nd:YAG capsulotomy in both the SI 40 NB and SI 30 NB design than in the IOLs without capsulotomies. 2) The percentage of not in-the-bag fixated IOLs in both the SI 40 NB and SI 30 NB design was larger in the "Nd:YAG groups", without being statistically significant. 3) The "Nd:YAG groups" showed a significant higher amount of non overlapping clock hours of the CCC edge in relation to the optic rim. CONCLUSION: 1) The data confirm the clinical assumption that the incidence of PCO is correlated with the cortical clean up. 2) Our findings also support the clinical assumption, that poor IOL fixation increases the risk of PCO. 3) This study also verifies the relation of the CCC to PCO, namely a relatively small CCC covering the entire optic rim is best to reduce the Nd:YAG laser rate.

Cataract↗

PubMed2002

[Complications of a voluminous congenital ciliary body cyst].

BACKGROUND: Multiple cysts of iris and ciliary body may cause many complications such as acute or chronic angle closure glaucoma. PATIENT: We present a boy with multiple congenital cysts of the iris pigment epithelium and a voluminous cyst of the unpigmented ciliary body epithelium of the right eye. This resulted in lenticular astigmatism, concomitant strabismus divergens and subsequently to anisometropia. The voluminous cyst (8 x 12 mm in diameter) was folded around the lens, reached the optic axis and resulted in displacement of the lens and contact between the iris and the corneal endothelium from 6.30 to 11. After puncture and partial resection of the cyst at the age of 8 months the boy developed a subcapsular multivesicular cataractic clouding of the temporal lens and a progredient myopia (up to - 14.0/- 2.0/0 degrees ); in contrast the left eye was hyperopic (+ 3.5/- 3.75/0 degrees ). The lens was subluxated superonasally due to congenital damage of the zonular fibres. Because development of visual acuity seemed limited by these determinants (20/200 at the right eye), cataract surgery with posterior capsulorhexis, anterior vitrectomy, and implantation of a capsular tension ring and posterior chamber intraocular lens was performed at the age of nearly five. Actually, there is an orthotropia, best corrected visual acuity in the distance of 20/32 in the right and 20/20 in the left eye; binocular vision is somewhat restricted. CONCLUSION: Usually congenital cysts are clinically not very relevant; occasionally surgical intervention is required to ensure adequate development of visual acuity.

Anisometropia↗

PubMed2006

[Pharmacological means to prevent secondary cataract].

Secondary cataract or posterior capsule opacification (PCO) is still the most frequent long-term complication of cataract surgery. Tremendous advances have been made, especially during the last 10 to 15 years, in terms of surgical techniques and improvement of implant technology. However, the problem of proliferation and migration of lens epithelial cells (LECs) postoperatively has not yet been solved completely although we know that a sharp optic edge of intraocular lenses (IOL) combined with hydrodissection, complete overlapping of capsulorhexis and IOL-optic as well as capsular bending reduce PCO formation significantly. In the 1980 s, investigators like Hartmann et al. began with the application of pharmacological substances in-vitro in order to successfully prevent LECs from proliferating and migrating. Cytostatic drugs, steroids, non-steroidal antiphlogistics, adhesion inhibitors, heparin, lidocaine, suramin, immunotoxins, photodynamic therapy and osmotic effective solutions were tested. In several studies different drug delivery systems were investigated in order to provide a longer and more effective impact on LECs. However, the in-vivo use has been viewed critically since the selective targeting of LECs was not possible and serious damage to the surrounding tissue had to be considered. Recently, the development of the PerfectCapsule System for vacuum-sealed capsule irrigation allows the selective targeting of LECs inside the capsular bag. This survey gives an update on past, current and future means and trends to reduce or prevent PCO formation pharmacologically.

Anti-Inflammatory Agents↗

PubMed1999

[Hyperplastic persistent pupillary membrane--surgical procedure].

BACKGROUND: Persistent pupillary membranes are a common congenital anomaly seen in 95% of neonates. Extensive persistent pupillary membranes, occluding the visual axis and resulting in reduced visual acuity, are relatively uncommon. CASE REPORT: A 4-year-old male infant was seen in our hospital with reduced visual acuity of his left eye. Slit-lamp examination revealed a dense, extensive, persistent pupillary membrane associated with anterior polar cataract. We performed an excision of the pupillary membrane, lens aspiration of the lens material, posterior capsulorhexis, anterior vitrectomy and placement of a posterior chamber-intraocular lens in the capsular bag. 8 weeks after operation visual acuity improved to 0.25. CONCLUSIONS: Dense pupillary membranes associated with polar cataract require early surgical treatment. Membranectomy, lens aspiration and implantation of an intraocular lens clear the visual axis and optimize the treatment of amblyopia.

Cataract↗

PubMed1997

[Single step implantable plate-haptic silicone lenses using the Passport system--initial experiences and results].

BACKGROUND: A new IOL implantation technique introduced in Germany since December 1995 is presented--the one-piece-plate-haptic silicone lens implantable with the Passport system. METHOD: From January to September 1996 in 291 patients after 3.2 mm clear cornea incision, capsulorhexis, phacoemulsification and implantation of an one-piece silicone posterior chamber lens with an implantation system was performed. The early post-operative results like visual outcome, astigmatism and complication rate are presented and compared to a group of 100 patients with implanted foldable three-piece silicone posterior chamber lenses. RESULTS AND DISCUSSION: The first post-operative day no statistically significant differences in visual outcome (mean: one-piece 0.71; three-piece 0.69), in absolute astigmatism (mean diopter 0.82 one-piece; 0.91 three-piece), in axial position and in complication rate were detectable. Differences of this new implantation technique compared to the conventional technique are discussed. CONCLUSION: The implantation of one-piece silicone lenses with the Passport system is a reliable and high quality alternative to conventional systems.

Aged↗

PubMed1996

[Anterior high-frequency capsulotomy: advantages and problems].

METHODS: Since the clinical test phase, the author performed consistently more than 500 capsulotomies in his cataract surgeries by means of a radio-frequency current, using an instrument developed by Klöti et al. Some problems in the application of the instrument and their possible solution are discussed from the practical view of the user. CONCLUSIONS: The method proved as easy and safe to use especially in certain difficult cases. The main problem seems to be a reduced stability of the anterior capsular rim compared to the cases performed by capsulorhexis.

Cataract Extraction↗

PubMed1996

[Phacoemulsification and clear cornea incision: review of 100 initial cases].

AIM: Evaluation of complications during the learning period of phacoemulsifications with clear-corneal incision. PATIENTS AND METHODS: Retrospective study of the 100 first cases with a follow-up of 3 to 24 months. RESULTS: During operation, 5 (5%) cases (one 180 degrees dialysis, 4 broken posterior capsules) presented with a significant complication needing anterior vitrectomy. Eight corneal tunnels were sutured at the end of surgery and 3 others a few days later. No case showed signs of intraocular infection. Cystoid macular edema developed in 4 patients who all recovered good visual acuity. Excessive fibrosis of anterior capsule with capsulorhexis contraction was encountered in 2 cases harbouring plate haptic silicone lenses and needed YAG-laser treatment. None of the eyes with complications had visual acuity inferior to 0.6, except for 2 eyes which had preoperative macular diseases. CONCLUSION: This study demonstrates that phacoemulsification with clear cornea incision is a safe procedure, provided that the complications related to the learning period are set apart. None of the complications encountered in our 100 first cases severely prejudiced the functional results.

Adult↗

PubMed1995

[Foldable implants in cataract surgery at the Geneva Ophthalmological Clinic].

PURPOSE: Since 1993, foldable intraocular lenses (Adatomed 90 D, Allergan SI26NB et SI30NB, Chiron C10, Medilas 127) have been implanted through a corneal or scleral tunel after phakoemulsification of the cataract. This retrospective study is made for evaluating the advantages and the disadvantages of these new silicon implants. PATIENTS AND METHOD: The first 250 implantations of a silicon foldable lens compared to 50 rigid PMMA lenses. Problems during implantation, final visual acuity, opacification of the anterior and posterior capsule, decentration of the lens and the stability of the refraction during the 3-19 months following cataract extraction were evaluated. RESULTS: 4 breaks of the capsule, 2 desinsertions of the capsular bag during the implantation of a foldable lens, a difference of less than 0.5 diopter in favour of the foldable lenses, no difference in the incidence of the secondary cataract (p = 0.3) and a more marqued postoperative opacification of the anterior capsule (p = 0.0275) among the foldable silicon lenses were observed. CONCLUSIONS: These results are very encouraging for the visual outcome, but the time of postoperative observations is too short to determine on a long term basis, which is the most important factor for a new implant. To avoid an early opacification of the anterior capsule, a large capsulorhexis, as wide as the optic of the silicon lens, is recommended.

Adolescent↗

PubMed1994

[Suitability of the open loop lens Phacoflex XI-30 for capsular sick implantation by self-sealing sclerocorneal tunnel incisions].

SCOPE OF THE STUDY: We studied a new intraocular lens implant with a high-refractive silicone optic and prolene C-loops. Suitability for folding and implantation with the recommended instruments as well as its performance as a capsular bag implant were evaluated. The impact of the self-sealing wound construction used on postoperative corneal stability was also studied. PATIENTS AND METHODS: We included 35 consecutively operated eyes. Capsulorhexis and phacoemulsification were performed. A well-centered and round 4-5 mm anterior capsular opening was aimed at. Using the Fine Universal or the Livernois-McDonald folder the optic was folded lengthwise and the leading loop tucked within the crease. The lens was implanted through a self-sealing sclerocorneal tunnel which measured 3.0 mm in length and 3.2 mm in width. RESULTS: With the instrumentation described, a 3.2 mm incision was adequate. - The lens centered well. In one case each decentration resulted from an optic-edge-by-rhexis-rim capture with an inappropriately shaped rhexis and from excessive capsular bag shrinkage with a too small rhexis. As a rule, the posterior capsule was distended and, with five exceptions, firmly attached to the optic. Fibrosis had resulted in only two cases where the rhexis had evaded the optic edge. Except for a single case where a filtering procedure had been simultaneously performed, optic-to-iris clearance was pronounced in all cases. Consequently, signs of iris chafing were never seen and iridocapsular synechiae had never formed in the latter. - Typically, fine granules scattered within the material and a bluish-violet tint were noted. However, neither intensive haze nor brownish discoloration as well as shell- or inner contour-phenomena were never present. - Vector analysis showed a negligible initial astigmatic shift against the wound that did not progress further on. CONCLUSION: This new implant performs very satisfactory. It may be even further improved by eliminating the granular inclusions and increasing the haptic rigidity. In order to prevent fibrotic opacification of the posterior capsule full circular overlap of the optic periphery by the anterior capsular leaf should be aimed at. The advantage of the reduced incision width required for insertion makes it very appropriate for clear corneal incision surgery.

Aged↗

PubMed1994

Manual ECCE, the present state of the art.

BACKGROUND: Manual ECCE has proved to be safe surgery compatible with small incision, no stitches, possible topical anesthesia, very cost effective and quick rehabilitation. The technique has a learning curve and needs experience. "Mini-nuc" stands for mini nucleus. This surgery can be achieved only if performed under positive intraocular pressure (IOP). METHODS: A BSS bottle is connected to the eye by an anterior chamber maintainer (ACM). The height of the BSS bottle controls the IOP during the surgery. Controlled IOP is a principle suggested for all kinds of cataract surgery. It creates continuous flow which washes out of the eye cortex debris, blood, pigment, etc. The BSS contains antibiotics and adrenalin, it creates low turbulence due to the small amount of BSS used per case, 30-50 cc. A round capsulorhexis is essential. A special way of hydrodissection creates a very small hard core nucleus delivered to the anterior chamber and is extracted out through a sclero-corneal tunnel using a glide introduced under the nucleus to guide the nucleus out. RESULTS: Positive IOP during all stages of surgery creates the best operative conditions for controlled surgery throughout all manipulations. This technique is a very cost effective system and at the same time provides a high quality procedure.

Anterior Chamber↗

PubMed1994

[Pseudoexfoliation syndrome--a risk factor in modern cataract surgery?].

BACKGROUND: The pseudoexfoliation (PEX) syndrome has been described in the ophthalmic literature as a major risk factor of cataract surgery. Most of the authors have reported extracapsular cataract extraction (ECCE) complication rates of more than 10% for zonular dialysis, capsular rupture, and vitreous loss. However, Osher et al. (1993) found that these complications from in situ phacoemulsification (PE) cataract surgery were less than 1%. We compared ECCE with PE by using the same surgeons for both procedures and evaluated retrospectively the complications for each in our patients. PATIENTS AND METHODS: Of 10,450 patients who underwent cataract surgery from 1986 to 1993, 102 PEX cases (0.98%) occurred. ECCE was performed on 34 of these patients, PE on 68 of the 102 patients. The average age of the PEX patients was 78 years. Miosis of 4 mm or less occurred in 19 eyes. To dilate the pupils, sphincterectomies were performed and iris retraction hooks were applied to the iris in the last two years. Eight surgeons (four with long-term experience and the remainder in training) performed the operations. RESULTS: The complication rates were 16.6% altogether for zonular dialysis, capsular rupture and vitreous loss, 26.47% for ECCE, and 11.76% for PE (p = 0.0664), in contrast to 1.3% for uncomplicated age-related cataract operations. However, these complications occurred in 14.28% of the ECCE patients and 9.09% of the PE patients with more or less normal dilation of the pupil. Still PE with miosis had fewer complications (23.07%) and was, thus, significantly safer (p = 0.0022) than ECCE (83.33%). Slight phakodonesis, observed during capsulorhexis, and an additional diagnosis of chronic open-angle glaucoma did not provide significant differences between the two surgical methods resulting in PEX. CONCLUSION: Miosis is beside phacodonesis the primary risk factor of PEX associated with cataract surgery. Compared with ECCE, PE had significantly fewer complications from PEX with miosis, not from PEX with phacodonesis. Applying the small iris retraction hooks appeared to decrease the complication risks stemming from miosis.

Adult↗

PubMed1993

[Experiences with disc lenses composed of silicone].

Our study presents the results with a silicone disc-lens (Adatomed 90D) over a postoperative period of 18 months. It includes 47 patients, 42 could be reexamined. The implantation was done after continuous circular capsulorhexis and phacoemulsification with a Faulkner-folder directly into the capsular bag. The implantation was sometimes difficult. Skill and experience of the surgeon are required. The IOL springs forth of the implantation forceps, which can lead to traumatization of the capsule and the iris. Three times the posterior capsule ruptured, in two cases the implantation was stopped because of vitreous pressure and the risk of rupturing the capsule. In 6 cases the rim of the anterior capsule ruptured during the implantation. Postoperatively one IOL had a sulcus position, all other IOLs were in the capsular bag. A deposit of viscoelastic substance (Healon) between the IOL and the posterior capsule in 34 cases (72%) was remarkable. In 14 cases (33%) it remained for 18 months. 16 times (38%) regeneratory after-cataract reached the central part of the capsule. The visual disturbance was different, in 6 cases (14%) a YAG-laser-capsulotomy was performed. An influence of the deposit of viscoelastic substance on the development of posterior capsule opacification could not be proved. 17 IOLs (40%) were minimally decentrated upwards. Only 11 cases (26%) had an excellent mydriatic pupillary reaction. The reason is not clear. 10 eyes (24%) developed iridocapsular synechia, 22 eyes (52%) foreign body giant cells and 20 eyes (48%) dispersed pigment on the IOL surface. The giant cells did not diminish.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1993

[Comparison of phacoemulsification and planned extracapsular cataract extraction].

40% of cataract surgeons in German speaking countries use phacoemulsification as the procedure of choice for cataract extraction while the other 60% still use the planned extracapsular extraction. The more procedures a surgeon performs the stronger is the tendency toward performing phacoemulsification. The opening technique of the anterior capsule is chosen accordingly: for phacoemulsification capsulorhexis is preferred, while for the planned extracapsular extraction can opener - or letter box - technique is usually done. The length of the sclero-corneal incision is 3.2 mm in phacoemulsification, 6.2 mm for a PMMA posterior chamber lens implantation and 9-13 mm for the planned extracapsular extraction. We prospectively compared both procedures with each group including 100 consecutive patients. The mean irrigation volume was 96.6 +/- 48.8 ml in the phacoemulsification group as opposed to 48.1 +/- 26 ml in the planned extracapsular extraction group. The mean duration of irrigation was 130 +/- 67 sec in the first versus 129 +/- 76 sec in the second group; mean endothelial cell loss was 7.9% versus 7.1%. No correlation was found between endothelial cell loss and duration of irrigation. Mean postoperative astigmatism measured 1.0 +/- 0.49 in the first group as compared to 3.3 +/- 1.7 dpt in the second group. Except for the astigmatism, our study could not detect significant differences regarding the outcome between both procedures. There are advantages to the phacoemulsification procedure, however, such as a smaller incision (e.g. tunnel technique), a closed irrigation-aspiration system, controlled intraocular pressure and the more frequent use of capsulorrhexis. Preferred indications and possible advantages regarding intra- and postoperative complications are discussed.

Aged↗

PubMed1989

[Technic and initial results of capsule sack implantation of hydrogen lenses using a small incision].

Hydrogel lenses are flexible and hydrophilic. The IOGEL lens can be folded with Faulkner forceps and implanted through a 3.5 mm incision. Inadvertant contact with the endothelium causes only minimal cell loss. In April 1988, the authors switched from sulcus to bag fixation and have since inserted 35 lenses. Capsulorhexis appears to guarantee stability and centration. Complications are rare and minor in nature, and can be avoided by adopting an appropriate technique. While retaining all the advantages of phacoemulsification, the procedure considerably accelerates physical and visual rehabilitation. However, long-term results must be awaited.

Aged↗

PubMed2002

Vitreoretinal management of posteriorly dislocated plate haptic silicone intraocular lenses.

PURPOSE: To report the vitreoretinal management of posteriorly dislocated plate haptic silicone intraocular lenses (PHSIOLs) and to present a surgical algorithm for this problem. METHODS: A retrospective analysis of 12 cases of immediate and delayed posterior dislocation of a PHSIOL after phacoemulsification was performed. RESULTS: The ages of the patients ranged from 26 years to 82 years (mean, 68 years); six of the patients were male. Delayed posterior dislocation of the PHSIOL occurred in 7 eyes (after Nd:YAG laser capsulotomy in 4 cases), while intraoperative dislocation occurred in 5 eyes. Defects of the anterior capsulorhexis rim or posterior capsule were present in nine eyes. The mean time from PHSIOL dislocation to definitive treatment was 4.8 months (range, 0.25-13 months). All patients underwent pars plana vitrectomy and implant exchange or repositioning. The dislocated PHSIOL was removed through the transpupillary route in 8 cases, while it was segmented and delivered through the pars plana in 3. Two patients underwent implant repositioning in the ciliary sulcus, although subsequent redislocation in one case required transpupillary removal and exchange. The mean follow-up period was 6.5 months (range, 2-18 months), with a final best corrected visual acuity of 6/12 or better in 10 eyes. CONCLUSIONS: Delayed and immediate dislocation of PHSIOL can occur in eyes with a defect in capsular integrity. The implant may be repositioned or exchanged following vitrectomy with either transpupillary or pars plana removal, resulting in generally excellent postoperative visual acuity and minimal complications.

Adult↗

PubMed1991

Cataract surgical techniques.

Cataract surgical techniques are constantly evolving and changing, offering the ophthalmologist new and sometimes improved options for optimal visual rehabilitation of their patients. This article reviews the surgical techniques used in cataract surgery with an emphasis on the recent literature. The following areas are covered: anesthesia, incisions and wound closure, capsulotomy, planned extracapsular cataract surgery, phacoemulsification, intraoperative management of the torn posterior capsule, trauma, and combined procedures. The use of phacoemulsification continues to increase in popularity in the developed countries. Small incisions for cataract surgery hasten visual rehabilitation, and continuous circular capsulorhexis has emerged as an advantageous capsulotomy technique. With proper intraoperative management, patients with torn posterior capsules have excellent visual results. Combined procedures allow for concurrent surgery in patients with cataract and coexistent ocular diseases. Cataract surgical techniques must be adapted to suit each patient. The modification of surgical techniques according to individual patient needs and associated ocular and systemic disorders offers a distinct challenge to the ophthalmic surgeon.

Anesthesia, Local↗

PubMed1992

Intraocular lenses.

I have again reviewed the current state of the art in intraocular lens design in what has been a year of consolidation rather than dramatic discoveries. In foldable lenses, silicone reigns supreme, but there is the promising development of high-refractive-index foldable acrylic lenses. Heparin surface modification is now accepted as valuable in high-risk eyes, but there remains a question mark over surface passivation value. Small-incision lenses continue to proliferate with the design of new haptics to facilitate insertion after circular tear capsulorhexis. Some doubt has been raised concerning the optical qualities of ovoid lenses. Anterior-chamber myopic lenses for phakic myopic patients remain controversial. However, an increasing volume of data concerning their advantages and disadvantages is now available.

Biocompatible Materials↗