Complicated posterior capsulorhexis: aetiology, management, and outcome

Abstract

Conclusion-Loss of control of the posterior capsulorhexis has a low incidence but can lead to serious problems during surgery. A good knowledge of the technique is necessary to complete the procedure with a posterior capsulorhexis of the optimum size without vitreous loss. (Br J Ophthalmol 1997;81:195-198)

Routine posterior optic buttonholing for eradication of posterior capsule opacification in adults

“…With a PPCCC larger than the optic diameter, the optic may be safely fixated in the ACCC by buttonholing it anteriorly (with loops in the bag) or posteriorly (with loops in the sulcus). With a torn PPCCC, the Earlier findings with large PPCCC series 10,17,18 show that removing the central posterior capsule does not increase the rate of cystoid macular edema or RD. In the cases with central puncture of the anterior hyaloid membrane, or even in those with minor vitreous entanglement (without traction), these complications were not seen.…”

Lens epithelial cells in an in vitro capsular bag model: Lens-in-the-bag versus bag-in-the-lens technique

“…[4][5][6][7][8][9][10] Because of the great economic and functional burden of PCO, several surgical and nonsurgical strategies to prevent PCO have been proposed. These include the use of chemical substances and antibodies [11][12][13] ; hyperthermia 14 ; careful cleanup of the capsular bag 15,16 ; new IOL designs, coatings, and biomaterials [16][17][18][19][20][21][22][23] ; primary posterior continuous curvilinear capsulorhexis (PCCC) [24][25][26][27][28] ; and IOL capture or buttonholing. 29 The diversity of these recently developed therapeutical approaches relies on increased knowledge of the pathophysiology behind PCO, which is generally accepted to comprise 4 classic steps: (1) adhesion, (2) proliferation, (3) migration of the remaining LECs to the capsule, and (4) differentiation to myofibrotic cells.…”

“…From the literature, it is apparent that although many nonsurgical approaches have also been evaluated, only surgical methods have proved efficient in preventing PCO. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Our department developed a new type of IOL aimed at capturing the LECs in a closed area and blocking their migration toward the visual axis. The implantation concept is called the bag-in-the-lens (BIL) technique, in which both the anterior and posterior capsules are inserted in a groove at the margin of the IOL optic (Figure 1, top).…”

Effect of bag-in-the-lens implantation on posterior capsule opacification in human donor eyes and rabbit eyes

“…Removal of the central part of the posterior capsule by a posterior continuous curvilinear capsulorhexis (PCCC) prevents PCO in many cases, 26 but not all. [27][28][29] Especially in patients with uveitis and in children, PCO remains a major concern. 30, 31 We recently developed a new type of IOL that makes it impossible for LECs to migrate toward the visual axis.…”