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Results for “Capsulorhexis”

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PubMed1991

"Equator ring" for maintenance of the completely circular contour of the capsular bag equator after cataract removal.

We designed an "equator ring," a flexible silicone rod with a groove on its inner surface, to maintain the circular contour of the capsular bag equator after cataract removal. After cataract extraction, the ring is inserted in the bag through a 5.0-mm circular capsulorhexis or 4.5-mm linear "dumbbell" opening. Then a conventional posterior chamber intraocular lens (PC-IOL) is inserted, with the IOL loops in the groove. The ring not only allows complete maintenance of the circular contour of the capsular bag equator for most conventional PC-IOLs, but also may prevent invasion of metamorphosed lens epithelial cells into the posterior capsule.

Cataract Extraction↗

PubMed1991

A new look at postoperative instructions following cataract extraction.

We sought to determine whether, given the decreasing rate of complications associated with cataract surgery and IOL implantation, postoperative restrictions placed on patients undergoing these procedures could be significantly and safely relaxed. We reviewed the charts of 216 patients who had undergone capsulorhexis or "can-opener" capsulotomy, phacoemulsification, and insertion of an oval IOL over a 3-year period, noting any operative or postoperative complications. All of these patients had been examined the day after surgery and, if no complications were noted, had been instructed only to refrain from activities that produced pain. No shield was required, and no instructions were given to restrict showering, hair washing, or any other normal physical activity. We found no complications related to any postoperative activity. These results suggest that current postoperative instructions typically restricting such patients' activities should be reevaluated.

Aged↗

PubMed1991

Investigations on diathermy for anterior capsulotomy.

Diathermy is an approved instrument for intraocular surgery. The authors studied the effects and possible side effects of the first clinical application of a straight bipolar high-frequency probe used to cut the anterior capsule in extracapsular cataract exfraction (ECCE) with a continuous movement. In 25 patients with intumescent or mature cataractous lenses, on which capsulorhexis is difficult to perform, the anterior capsule was cut and a round capsulotomy of the desired diameter obtained. Simultaneously, intraocular temperature was measured for the first time in vivo inside the anterior chamber with a microtemperature probe during the operation. With the technique described, it reached a maximum of 33.4 degrees C (the maximum ranged from 32.8 degrees C-33.4 degrees C). There was no abnormal loss of corneal endothelial cells in the 12-month postoperative follow-up. In addition, electrolysis could not be verified experimentally.

Aged↗

PubMedDate not supplied

Continuous tear capsulotomy and phacoemulsification cataract extraction combined with penetrating keratoplasty.

Continuous tear capsulotomy, or capsulorhexis, permits secure and precise placement of a posterior chamber intraocular lens. This technique can be used open sky during triple procedures combining penetrating keratoplasty with cataract extraction and intraocular lens insertion. Expression of the nucleus through a continuous tear capsulotomy can be difficult. Incisions in the anterior capsule facilitate nucleus expression but can extend, obviating the advantages of continuous tear capsulotomy. With phacoemulsification using low irrigation and adequate ultrasound power, the nucleus can be completely emulsified or fragmented into easily removable pieces. This permits continuous tear capsulotomy to be part of triple procedure surgery.

Cataract Extraction↗

PubMed1990

[Prospective study of the incidence of secondary cataract with various types of lenses with and without laser ridge].

In this randomized, prospective clinical study, a plano-convex (plano-posterior) intraocular lens (IOL) with a laser ridge was compared with a plano-convex (plano-posterior) IOL without a laser ridge. The 100 patients (40 male/60 female) with senescent cataracts all underwent ECCE performed by the same surgeon from November 1986 to March 1987. The operative technique consisted of capsulorhexis, irrigation-aspiration and in-the-bag implantation. The first group of 50 patients (50 eyes) received a sort of IOL without a laser ridge and the second group, a sort with a laser ridge. Our prospective 5-year clinical study is not yet complete and no statistical analysis has been performed. As an intermediate result, however, we have found a rate of 11.7% for after-cateract in the group with an IOL without laser ridge and a rate of 28.6% in the group with an IOL with laser ridge.

Aged↗

PubMed1989

[Postoperative cataract following intraocular lenses with and without laser ridge].

In this randomized, prospective clinical study, a convex plane intraocular lens (IOL) with a laser ridge was compared with a convex plane IOL without a laser ridge. No difference was found in the reduction of capsular opacification 1 year after surgery. The 100 patients (40 males/60 females) with senescent cataracts were treated with ECCE by a single surgeon from November 1986 to March 1987. The operative technique consisted of capsulorhexis, irrigation-aspiration and in-the-bag-implantation. The first group of 50 patients (50 eyes) had an IOL without a laser ridge and the second group an IOL with a laser ridge. When considering after-cataracts in combination with minor visual deterioration we had secondary cataract rate of 15% in the IOL group with a laser ridge and of 16% in the IOL group without a laser ridge. When we considered only the cases in which visual acuity worsened and YAG laser capsulotomy was required, the secondary cataract rate was 1.5%.

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PubMedDate not supplied

Posterior lens dislocation during attempted phacoemulsification.

Mechanisms of posterior lens dislocation during phacoemulsification have been suggested, but the actual mechanism involved has not been demonstrated. Chart reviews of cataract surgeries performed at Indiana University from 1991 until the present identified nine cases of posterior lens dislocation that occurred during phacoemulsification. In four, the procedure was converted early to a can-opener capsulotomy. Cadaver eye studies showed the role of an imperfect capsulorhexis in extending tears while a "trap door" was being formed for posterior nuclear dislocation during phacoemulsification.

Aged↗

PubMed1995

[Human lens epithelial cell culture and its proliferative inhibition in vitro].

The cultures of human lens epithelial cells taken from both normal and cataractous lenses were established in vitro. The biological characteristics and the histological changes of the cells were investigated. 5-Fluorouracil (5-Fu), Homoharring tonine (HH) and Harmeline (H) were used for the inhibition of the proliferative cells in the experiment. The results revealed that the in vitro survival capacity of the human lens epithelial cells is limited and the proliferative capacity of the cells is negatively correlated to the donor age. HH and H can effectively inhibit the lens epithelial cell proliferation. Based on the results of this report, performing small and smoothly edged anterior capsulorhexis in extracapsular cataract extraction may possibly decrease the incidence of the post-operative opacification of the posterior capsule.

Adolescent↗

PubMed1995

[A comparison study of various anterior capsulectomies].

The incidences of anterior capsular radial tears occurring in different capsulectomies performed on rabbit eyes under standardized conditions were compared. The eyes were randomly divided into 4 technique groups: (1) can opener, (2) capsulopuncture, (3) linear capsulotomy and (4) continuous circular capsulorhexis (CCC). The results demonstrated that the CCC technique has more advantages in comparison with other three groups. With the nuclear expression technique used in this study, no radial tears occurred with the CCC technique, whereas radial tears occurred in 100% of cases treated with other three techniques.

Animals↗

PubMed1994

[Reasons for the explantation of posterior chamber lenses].

In this study we analysed the overall incidence and the types of complications seen after cataract surgery and implantation of posterior chamber intraocular lenses (PC-IOLs) based on a review of 1460 explanted PC-IOLs. Of these explanted PC-IOLs, 1072 (73.4%) were three-piece PMMA IOLs with Prolene haptics, 261 (17.9%) were one-piece all-PMMA IOLs, 81 (5.6%) were silicone IOLs and 46 (3.1%) were of various other designs (multifocal IOLs, disc IOLs etc.). The mean implant duration for all IOLs was 25.57 +/- 29.24 months. The two most important reasons for explantation were IOL decentration (622/1460, 42.6%) and inflammation (347/1460, 23.77%). There was no difference in reasons for explantation between one-piece and three-piece IOLs. Operative techniques such as "can opener" capsulotomy and sulcus fixation have more influence on IOL decentration than the IOL design alone. Modern operative techniques such as continuous curvilinear capsulorhexis, phacoemulsification and symmetrical in-the-bag fixation of "capsular IOLs" should decrease the explantation and complication rate in the future.

Follow-Up Studies↗

PubMed1993

Circular continuous anterior capsulotomy with high frequency diathermy.

Recently a new device (Klöti) has been commercialized which is able to cut the anterior lens capsule by high frequency (HF) diathermy without coagulating or tearing. The method is easy to learn. The properties of a continuous circular anterior capsulotomy performed thereby resemble those of a continuous circular capsulorhexis. In 48 consecutive cases with a follow up of more than 15 months we found no significant difference between rhexis and HF diathermy capsulotomy as far as rigidity or elasticity of the anterior capsular opening is concerned. There was also no difference between HF diathermy and conventional capsulotomy regarding corneal decompensation, posterior synechiae or lens decentration.

Cataract Extraction↗

PubMed1994

[Exfoliative syndrome and phacoemulsification].

PURPOSE: Exfoliation syndrome (ES) is often considered as a poor indication for phacoemulsification because of zonular weakness, capsular weakness and poor pupil dilatation. METHODS: We evaluated from January 1992 to December 1992 a series of 107 consecutive eyes with ES and undergoing cataract surgery or combined cataract-glaucoma surgery. The pupil was surgically enlarged if the diameter was < or = 5 mm. RESULTS: During surgery, only one case of zonular dialysis without vitreous loss was observed. The incidence of postoperative complications was low (6 hyphemas and 8 inflammatory reactions) and visual results were satisfactory. CONCLUSION: Phacoemulsification can be used routinely in eyes with ES if a careful peroperative protocol is followed: pupillary dilatation, wide capsulorhexis, total nucleus hydrodisection.

Aged↗

PubMed1993

[Phacoemulsification. Towards a cataract surgery without sutures].

The surgeon presents the results of the first phacoemulsification procedures he performed. The procedure includes capsulorhexis and phacoemulsification within the bag in the posterior segment. This technique results in safe fixation of the intraocular lens implant in the bag.

Adult↗

PubMed1993

[Retinal periphery and diameter of the optic implants in the posterior chamber (5, 6, 7 mm)].

In a preliminary study of 35 patients that had undergone cataract extraction surgery, we compared the visualization of the retinal periphery according to the intraocular lens optic diameter (5, 6, and 7 mm). In all cases, we performed extra-capsular cataract extractions, with a capsulorhexis, and a Posterior Chamber lens. Indirect ophthalmoscopy with scleral depression, and Goldmann lens biomicroscopy were used to visualize the fundus. We found the smaller the optic diameter was, the better the visualization of the peripheral retina was. Indeed there was a wider space between the optic ridge of the lens and the iris. There was also a better transparency of the peripheral capsular bag.

Aged↗

PubMed1994

[Functional evaluation of a new type of intraocular lens: Domilens type PROGRESS 1].

This study presents the first clinical and functional results on the implantation of a new multifocal IOL model, the Domilens type PROGRESS 1. A group of 20 patients underwent extracapsular extraction of cataract with continuous circular capsulorhexis and IOL implantation in the capsular bag. In 65% of the cases, final visual acuity from a far distance proved to be greater than or equal to 8/10 without correction, while visual acuity from a short distance was J2 without the need of additional lenses. BAT identified a decrease in visual acuity of 0.01 Snellen lines at a medium lighting level and 0.05 at the maximum level. The perimetric results obtained with the C 30-2 threshold programme of the Humphrey field analyzer showed a foveal sensitivity threshold of 32.5 dB +/- 9.25 dB and a mean defect of -2.22 dB +/- 2.90 dB. The Vistech VCTS 6500 underlined a decrease in the sensitivity to space frequency contrast of 6.0 c/d versus a control group of patients with monofocal IOL (P < 0.05). This reduction involved a wider range of space frequencies (3.0, 6.0, 12.0 c/d) in comparison with a group of phakic subjects (P < 0.05). With the on-off PEV patterns, a slight decrease in contrast sensitivity threshold was found versus patients with monofocal IOL statistically non significant (P > 0.05). At a medium space frequency of 2.33 c/d, a decrease in contrast sensitivity versus phakic subjects (P < 0.05) was observed. Depth of focus went from infinite to 19 cm. from the eye.

Aged↗

PubMed1993

[Histopathological study of rabbit anterior capsule opacification after IOL surgery].

We investigated the histopathology of anterior capsular opacification after intraocular lens (IOL) implantation in a rabbit eye. Sixteen eyes of eight albino rabbits underwent continuous circular capsulorhexis, phacoemulsification, and in-the-bag IOL implantation. The anterior capsules were examined by slitlamp, light microscopy, and transmission electron microscopy. Anterior capsular opacification during the fourth week after surgery appeared similar to that of the human eye. Multi-layered lens epithelial cells and collagenous fibers were recognized in the anterior capsular opacification. New lens fibers, however, extended between the anterior capsules and the IOLs, and caused the opacification to become obscure. This model may be useful for investigating anterior capsular opacification after cataract surgery during the early postoperative period.

Animals↗

PubMed1993

[Findings from slit lamp and histological examination of the anterior capsule in patients with severe anterior capsular shrinkage and opacities after implantation of intraocular lenses].

Seven pseudophakic patients with severe anterior capsular shrinkage and opacities after continuous curvilinear capsulorhexis as a severe anterior capsular shrinkage group and seven pseudophakic patients without the complication as control group were studied in a slit lamp examination of zonular fibers and anterior vitreus body with an indentation mirror. A light and electron microscopic study of the shrunken anterior capsular edge was performed in one case of the severe anterior capsular shrinkage group. No morphological findings suggesting weakness of zonular fibers such as cleavage or scarceness were observed, but reduction in elasticity of the zonular fibers was surmised and degeneration and liquefacation of the anterior vitreus body was observed in the severe anterior capsular shrinkage group. Histological study revealed several layers of proliferated spindle cells and also abundant extracellular matrix, consisting of collagen types I, III and IV, under the monolayer of lens epithelium attached to the anterior capsule. Spindle cells were epithelial cells and considered to be derived from lens epithelium, because the spindle cells were connected by junctional apparatus, which is a feature of epithelium. Severe anterior capsular shrinkage and opacities were due to low ability of the lens supporting system of zonular fibers and anterior vitreus and severe scarring and shrinkage at the anterior capsular edge.

Aged↗

PubMed1993

[The effect of intraocular lens (IOL) length and design on anterior chamber depth under contraction and relaxation of the ciliary muscle].

We compared the effect of intraocular lens (IOL) length and its design on the anterior chamber depth (ACD) change during contraction and relaxation of the ciliary muscle. We performed phacoemulsification or extra capsular cataract extraction using continuous circular capsulorhexis on 100 eyes, and implanted in 23 eyes a short one-piece IOL, in 22 eyes a short three-piece IOL, in 25 eyes a long one-piece IOL, and in 30 eyes a long three-piece IOL. All IOLs were fixed in the capsular bag. ACD changes after administration of 2% pilocarpine and 1% cyclopentolate were measured with a pachymeter between 3 and 6 months postoperatively. The compatibility of the IOLs with ciliary muscle contraction and relaxation was, in descending order, the short one-piece IOL, the short three-piece IOL, the long one-piece IOL, and the long three-piece IOL. The results indicated that short IOLs are more physiologically fixed in the capsular bag, with less stress on the zonules of Zinn.

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