Complications and Outcomes of Phacoemulsification Cataract Surgery Complicated by Anterior Capsule Tear

Carifi, Gianluca; Miller, Michael H.; Pitsas, Christos; Zygoura, Vasiliki; Deshmukh, Rajesh R.; Kopsachilis, Nikolaos; Maurino, Vincenzo

doi:10.1016/j.ajo.2014.11.027

Cited by 36 publications

(24 citation statements)

References 22 publications

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“…Literature suggests that patients with a history of intravitreal injections are associated with an increased risk of PCR, presumably as a result of iatrogenic lens trauma following the injection process. 22 Intraoperatively, Carifi et al 23 found that almost one-quarter of eyes with anterior capsular tears proceeded to posterior tears, highlighting the importance of early recognition of warning signs.…”

Section: Discussionmentioning

confidence: 99%

Posterior capsular complication rates with femtosecond laser-assisted cataract surgery: a consecutive comparative cohort and literature review

Levitz¹,

Reich²,

Hodge³

2018

OPTH

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PurposeThe aim of the study was to determine whether femtosecond-assisted laser cataract surgery (FLACS) reduces the posterior capsular complication (PCC) rate compared to manual cataract surgery when performed by an experienced surgeon.Patients and methodsWe reviewed 2,021 consecutive FLACS procedures between 1 June 2012 and 30 August 2017. All cases of posterior capsular rupture (PCR) with or without vitreous prolapse or zonular dialysis (ZD) that prevented an in-the-bag placement of the intraocular lens were included. Risk factors were noted and outcomes documented.ResultsSix eyes of 2,021 (0.3%) who underwent FLACS had either a PCR or ZD. One eye (0.25%) of 403 eyes that had manual cataract surgery had a PCR. There was no significant difference in outcomes. Risk factors included advanced age, dense nuclei, pseudoexfoliation and small pupil. Only a single case in the FLACS series may have been directly attributed to the FLACS procedure.ConclusionThis study provides evidence that there is no significant difference in the PCC rate between FLACS and manual cataract surgery in the hand of an experienced surgeon who performs >350 cases annually. This low rate of complications may be achieved by less experienced surgeons adopting FLACS.

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Section: Discussionmentioning

confidence: 99%

Posterior capsular complication rates with femtosecond laser-assisted cataract surgery: a consecutive comparative cohort and literature review

Levitz¹,

Reich²,

Hodge³

2018

OPTH

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“…However, the demographic characteristics and high cost of surgery poses a great economic burden for society, especially in developing countries [2]. In addition, irreversible vision-threatening surgery-associated complications may also occur [3]. Thus, alternative pharmacological therapy is still required to prevent or delay senile cataract development.…”

Section: Introductionmentioning

confidence: 99%

Long Non-Coding RNA H19 Regulates Human Lens Epithelial Cells Function

Liu

Shan

et al. 2018

Cell Physiol Biochem

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Background/Aims: Age-related cataract (ARC) remains the leading cause of visual impairment among the elderly population. Long non-coding RNAs (lncRNAs) have emerged as potential regulators in many ocular diseases. However, the role of lncRNAs in nuclear ARC, a subtype of ARC, requires further elucidation. Methods: LncRNA sequencing was performed to identify differentially expressed lncRNAs between the capsules of transparent and nuclear ARC lenses. Expression validation was confirmed by qRT-PCR. MTT assay, Calcein-AM and propidium iodide double staining, Rhodamine 123 and Hoechst double staining, EdU and transwell assay were used to determine the role of H19 or miR-675 in the viability, apoptosis, proliferation and migration of primary cultured human lens epithelial cells (HLECs). Bioinformatics and luciferase reporter assays were used to identify the binding target of miR-675. Results: Sixty-three lncRNAs are differentially expressed between the capsules of transparent and nuclear ARC lenses. One top abundantly expressed lncRNA, H19, is significantly up-regulated in the nuclear ARC lens capsules and positively associated with nuclear ARC grade. H19 knockdown accelerates apoptosis development and reduces the proliferation and migration of HLECs upon oxidative stress. H19 is the precursor of miR-675, and a reduction of H19 inhibits miR-675 expression. miR-675 regulates CRYAA expression by targeting the binding site within the 3’UTR. Moreover, miR-675 increases the proliferation and migration while decreasing the apoptosis of HLECs upon oxidative stress. Conclusion: H19 regulates HLECs function through miR-675-mediated CRYAA expression. This finding would provide a novel insight into the pathogenesis of nuclear ARC.

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“…In a Moorfields Eye Hospital study of anterior capsular tear extension, a high rate (24%) of posterior capsular rupture, with 5% nuclear drop and 11% requiring a secondary procedure, was reported. 27 In a study by Marques et al, the incidence of extension of the anterior capsule to the posterior capsule through the equator was noted as ~52%. 1 …”

Section: Discussionmentioning

confidence: 97%

Flap motility as a sign of posterior capsule rupture in peripherally extended anterior capsular tears

Parkash¹,

Mahajan²,

Biala³

et al. 2017

OPTH

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PurposeTo describe various types of anterior capsular tears and an early diagnostic, flap motility, as a sign of posterior capsular rupture following posterior extension of radial tears.DesignThis was a prospective study carried out in 4,331 eyes that underwent phacoemulsification in a private practice setting from April 2015 to February 2016. Twenty six consecutive cases of anterior capsular tears were included. Morphological features of anterior capsular tears and resultant complications were evaluated. Parameters studied were surgical step during which the tear occurred, shape of tear, its extension in relation to the equator, and flap nature and motility in tear extending up to equator.Main outcome measuresThe main outcome measures were motility and nature of flaps in anterior capsular radial tears and the relation to posterior capsule rupture.ResultsBased on shape, extent, and angulation, anterior capsular tears were categorized into 5 types: Type I, pre-equatorial radial tear (26.92%); Type II, post-equatorial radial tear (3.85%); Type III, Argentinean flag sign pre-equatorial tear (57.69%); Type IV, Argentinean flag sign post-equatorial tear (7.69%), and Type V, mini punch (3.85%). Flaps were either seen to be everted and fluttering or inverted and non-fluttering. In all cases with everted fluttering flaps no posterior capsular rupture (PCR) was observed, while in cases with inverted non-fluttering flaps a PCR was observed (p<0.05).ConclusionEverted and fluttering flaps of the anterior capsular tears indicate pre-equatorial tear, while inverted and non-fluttering flaps indicate posterior capsule rupture following tear extension beyond the equator.

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Complications and Outcomes of Phacoemulsification Cataract Surgery Complicated by Anterior Capsule Tear

Cited by 36 publications

References 22 publications

Posterior capsular complication rates with femtosecond laser-assisted cataract surgery: a consecutive comparative cohort and literature review

Posterior capsular complication rates with femtosecond laser-assisted cataract surgery: a consecutive comparative cohort and literature review

Long Non-Coding RNA H19 Regulates Human Lens Epithelial Cells Function

Flap motility as a sign of posterior capsule rupture in peripherally extended anterior capsular tears

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