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PubMedDate not supplied

Multifunction vitreous forceps (maculorrhexis forceps).

We developed novel multifunction vitreous forceps to decrease the frequency of forceps insertion and enable the removal of the internal limiting membrane and other intravitreal membranes for better surgical results. The basic forceps were conventional continuous curvelinear capsulorrhexis (CCC) forceps. The size of the shaft is 23G and its pointed end measures 500 microm in diameter. Additionally, there is a platform in its tip. The pointed end with platform helps to hold the membrane because the outer sheath can be moved while the tip of the forceps is fixed in position, and its pen hold type grip helps to reduce hand movement. The most advantageous thing is that the sharp point enables us to make an initial flap easily and the desired area of internal limiting membrane can be peeled off by firmly holding the platform.

Capsulorhexis↗
PubMed2002

"String of pearls" following Nd:YAG laser posterior capsulotomy.

Posterior capsular re-opacification can occur following Nd-YAG capsulotomy. This necessitates multiple capsulotomies with its potential complications. We report one such case and discuss possible predisposing factors and preventive measures for this condition.

Capsulorhexis↗
PubMed2002

[Effect of YAG capsulotomy of secondary cataracts on visual functions].

1. 20 patients (20 eyes) with secondary cataract and best corrected visual acuity (BCVA) of 20/30 or 20/20 using Snellen charts were examined before Nd-YAG capsulotomy and 14 days postoperatively. 2. Contrast sensitivity (CS) was tested on a computerized system of the Contrast sensitivity 8010 type and on VCTS charts in 6 spatial frequencies, BCVA was measured on the logMAR charts with Landolt rings and influence of glare of 342.6 cd/m2 was tested using Brightness Acuity Tester (BAT). 3. BCVA (without and under glare) in patients before and after YAG capsulotomy was significantly lower compared to the control group (p < 0.001). Postoperative improvement of BCVA was markedly higher on logMAR charts (up to 6.6 standardized lines) than using Snellen charts (1 line). 4. CS (without and under glare) using both methods in patients before and after YAG capsulotomy was significantly lower compared to the control group (p < 0.05 to p < 0.001) in spite of significant improvement postoperatively (p < 0.05 to p < 0.001), first of all at intermediate and high spatial frequencies. 5. Glare had only nonsignificant influence on BCVA and CS in all groups.

Aged↗
PubMed2002

[Cataract surgery. Anterior capsulorrhexis technique].

The cataract surgery is in a continuous dynamic because of the technological progress. The last years the surgical technique for cataract has changed and the most important progresses are the use of small incisions that don't require sutures, the realise of the anterior capsulotomy with smooth margins (continuous circular capsulorrhexis) and the extracapsular extraction of the cataract by phacoemulsification. The authors described the most usual techniques of the anterior capsulotomy with the advantages offered by capsulorrhexis, an important surgical step from the manual extracapsular extraction of the cataract to phacoemulsification.

Capsulorhexis↗
PubMed2002

[Surgical prevention of posterior capsule opacification].

AIM OF STUDY: To evaluate a 20 years period of cataract surgery, in order to decrease the posterior capsule opacification. MATERIAL AND METHOD: 3320 eyes after cataract surgery with posterior chamber intraocular lens was examined for Soemmering ring. This appears before posterior capsule opacification. CONCLUSIONS: A very good clearing of lous cortex is very important in preventing posterior capsule opacification. If it also useful a correct hydrodissection.

Cadaver↗
PubMedDate not supplied

Capsular block syndrome in a case with excessive cortical remnants.

Ten days after cataract extraction with phacoemulsification and in-the-bag acrylic intraocular lens implantation, capsular block syndrome developed in the right eye of a 62-year-old man. Aspiration of the swollen cortical remnants resulted in resolution of the capsular block.

Capsulorhexis↗
PubMed2002

Results of Nd:YAG laser capsulotomy in posterior capsule opacification.

The most common postoperative complication of cataract extraction is posterior capsule opacification. It causes the deterioration of visual acuity, however, there is no effective method to prevent it. The posterior capsule opacification is treated by surgical or laser capsulotomy. The authors analysed the results of Nd:YAG application in discission of the opacified posterior capsule. Twenty-eight consecutive cases (23 patients) of extracapsular cataract extraction and phacoemulsification with implantation of posterior chamber intraocular lenses were reviewed. In all cases of capsulotomy the Nd:YAG laser of Q-switch Zeiss type was applied. The improvement of visual acuity was achieved in 25 cases (89%). The best visual acuity (0.8-1.0) was obtained in 72% of eyes and in 22% the improvement was from 0.25 to 0.5. In two cases visual acuity after capsulotomy deteriorated because of concomitant glaucoma. In one case repeated capsulotomy did not turn out to be successful. It was caused by diabetic neuropathy of the optic nerve. We did not observe any serious complications following Nd:YAG laser capsulotomy described by the others: the intraocular pressure elevation, cystoid macular edema, intraocular lens injury, retinal detachment, iridocyclitis. Nd:YAG laser capsulotomy is one of the best methods of treatment of posterior capsule opacification. It appears to be effective, safe, non-invasive and it does not require patient hospitalisation.

Aged↗
PubMed2003

[Use of indocyaine green staining technique for phacoemulsification in white cataract].

OBJECTIVE: To evaluate the efficiency and safety of indocyaine green (ICG) staining technique using in white cataract phacoemulsification. METHODS: In a prospective clinical study, 105 eyes with white senile cataract were divided into two groups: capsular-staining group using ICG (n = 55) and noncapsular-staining group (n = 50). The time for performing the circular continuous capsulorrhexis (CCC), the number of radial tears of anterior capsule, the number of the rupture of capsular bag and the incidence of IOL in-the-bag fixation during the operation were recorded. We also measured the intraocular pressure and observed the changes of corneal endothelial cells, the anterior chamber flare and the keratic precipitation before surgery, 1 day and 3 months after surgery, respectively. The results of these two groups were compared. The quantitative results were analyzed with two-tailed student's t-test, while the qualitative results were analyzed with chi-square test. RESULTS: In operations performed with ICG staining technique, the CCC could be performed more quickly, no radial tears of the anterior capsule or rupture of capsular bag occurred and all IOL could be fixed in the bag. No statistically significant difference could be detected in the occurrence of these four aforementioned changes between these two groups. None of these patients had an elevation of intraocular pressure. The anterior chamber flare, the corneal endothelial cell density, the percentage of hexagonal cells and the corneal thickness showed no statistically significant difference between these two groups before and after surgery. CONCLUSION: Indocyaine green dye staining is a safe and useful technique in the white cataract phacoemulsification. We suggested to use ICG staining technique in the white cataract phacoemulsification.

Aged↗
PubMed2003

[Yag-Nd posterior capsulotomy.When? Where? How?].

PURPOSE: To answer a few elementary questions raised when confronted with the patient with aftercataract: Which are the indications and counter indications of the posterior capsulotomy? How can be evaluated the degree of PCO (posterior capsule opacification)? Which are the ideal size and location of the capsular opening? Is it mandatory to dilate the pupil? What energies are to be used? Which would be the recommended follow-up pattern? METHOD: This paper is a retrospective analysis of the 956 posterior capsulotomies performed between January 2001 and December 2002 at Bucharest Eye Hospital, Ophthalmology III Clinic, Nd:Yag laser surgery department. RESULTS: The best outcome is obtained with the fewest complications when the following conditions are met: the capsulotomy is performed no sooner than 6 months postoperatively; the capsular opening is small--2 mm în diameter--but perfectly aligned relative to the pupil and the IOL (sometimes this is difficult to achieve and the surgeon must always bare în mind the geometry of the posterior chamber and the parallax effect); laser pulses have low energy and are posteriorly defocused; when energy higher than 2 mJ is employed, the capsulotomy is performed by applying punctures în a circular pattern instead of a crosslike rectilinear pattern (in the case of IOL pitting, the visual axis is spared). CONCLUSION: The Nd:Yag photodisruptive laser offers a swift, safe and elegant method for dealing with a common and disturbing complication of the modern cataract surgery, the posterior capsule opacification. The results are often spectacular from the patient's point of view, but one should not neglect the risks related to the posterior capsulotomy.

Capsulorhexis↗
PubMed2003

Cost analysis of cataract surgery with intraocular lens implantation: a single blind randomised clinical trial comparing extracapsular cataract extraction and phacoemulsification.

A randomised single blinded clinical trial to compare the cost of cataract surgery between extracapsular cataract extraction (ECCE) and phacoemulsification (PEA) was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM) between March and December 2000. A total of 60 patients were included in this study. The cost of a cataract surgery incurred by hospital, patients and households up to two months after discharge were included. The costs of training, loss of patients' income after discharge and intangible costs were excluded. Results showed that the average cost for one ECCE operation is RM1,664.46 (RM1,233.04-RM2,377.64) and for PEA is RM1,978.00 (RM1,557.87-RM3,334.50). During this short period of follow up, it can be concluded that ECCE is significantly cheaper than PEA by an average difference of RM 313.54 per patient (p < 0.001). Cost of equipment and low frequency of PEA technique done in HUKM were the two main reasons for the high unit cost of PEA as compared to ECCE.

Aged↗
PubMed2004

[Results of surgery on white cataract using trypan blue capsule staining to visualize capsulorrhexis].

PURPOSE: To evaluate surgery on white cataracts using trypan blue capsule staining. METHODS: A retrospective study comprised 64 eyes of 60 patients with white cataract that had surgery with trypan blue capsule staining. The average age was 62.4 years and progress observation periods were 5.6 months. The rate of successful continuous curvilinear capsulorrhexis(CCC), complications, visual acuity, intraocular pressure(IOP), flare value, and corneal endothelial cell loss were studied. RESULTS: The CCC was completed uneventfully in 93.8% eyes. Posterior capsule rupture occurred in 2 eyes, and early perforation in 1 eye. Accidental vitreous staining and endothelial staining with trypan blue were observed in 1 eye each. There were no postoperative complications associated with trypan blue. Forty-five eyes had a best corrected visual acuity of 0.8 or better at the last visit. Twelve eyes had some ocular pathology resulting in visual loss, and a reliable visual acuity test could not be performed in 6 eyes. The mean postoperative IOP was within the normal range. The mean postoperative flare returned to within normal range 1 month after surgery. The mean corneal endothelial loss was 13.7%, and that of eyes with nucleus of grade 2 or softer was only 2.9%. CONCLUSIONS: Cataract surgery using trypan blue was safe and effective in managing white cataracts.

Adolescent↗
PubMed2004

Prevention of posterior capsule opacification using different intraocular lenses (results of one-year clinical study).

AIM: To evaluate and to compare the preventive effect of different intraocular lenses from different material with a round or sharp optic edge design on posterior capsule opacification. METHODS: Our clinical study included 165 patients. Mean follow-up was 12.4+/-0.9 months, mean patient age was 67.5+/-7.8 years. Patients in the group 1 (n=46) were implanted acrylic three-piece hydrophobic intraocular lenses, sharp optic edge (AcrySof, MA3OBA, Alcon), in the group 2 (n=38)--acrylic hydrophobic single piece intraocular lenses, sharp optic edge (AcrySof, SA3OAL, Alcon), in the group 3 (n=39)--silicone three-piece intraocular lenses, sharp optic edge (CeeOn 911A, Pharmacia), and in the group 4 (n=42)--polymethyl methacrylate single piece intraocular lenses, round optic edge (Crystal, 5T, Alcon). The posterior capsule opacification was evaluated for the entire optic and in the central 3-mm zone using EPCO 2000 Software. RESULTS: Posterior capsule opacification values of the entire optic were 0.002+/-0.001 in the AcrySof MA3OBA group, 0.007+/-0.002 in the AcrySof SA3OAL group, 0.002+/-0.001 in the CeeOn 911A group, 0.029+/-0.008 in the polymethyl methacrylate intraocular lens group 6 months after surgery. The values were 0.011+/-0.005, 0.025+/-0.006, 0.014+/-0.005 and 0.122+/-0.021, respectively, one year after surgery. The intraocular lenses types with sharp-edge design (acrylic and silicone) showed significantly lower posterior capsule opacification values than round-edge optic design polymethyl methacrylate lenses (p<0.05). Posterior capsule opacification values of the central 3-mm zone were 0.000+/-0.000 in the AcrySof MA3OBA group, 0.001+/-0.001 in the AcrySof SA3OAL group, 0.000+/-0.000 in the CeeOn 911A group, 0.002+/-0.001 in the polymethyl methacrylate intraocular lens group 6 months after surgery. The values were 0.0001+/-0.0001, 0.018+/-0.007, 0.004+/-0.002 and 0.028+/-0.009, respectively, one year after surgery. Posterior capsule opacification values differences between AcrySof MA3OBA and polymethyl methacrylate intraocular lenses' groups and between CeeOn 911A and polymethyl methacrylate intraocular lenses' groups one year after cataract surgery were established (p<0.05). CONCLUSIONS: The sharp-edge foldable intraocular lenses types (AcrySof MA3OBA, AcrySof SA3OAL, CeeOn 911A) showed statistically significant difference in posterior capsule opacification values in one-year follow-up time. The effect of these foldable lenses for prevention of posterior capsule opacification is mainly a result of rectangular, sharp-edged optic design, which creates a sharp capsular bend. A role of material of intraocular lenses (hydrophobic acrylate and silicone) in prevention of posterior capsule opacification during one-year follow-up was not established.

Acrylic Resins↗