Managing anterior capsule contraction by mechanical widening with vitrector-cut capsulotomy

Yeh, Patrick C; Goins, Kenneth M.; Lai, Wico W.

doi:10.1016/s0886-3350(01)01031-8

Cited by 29 publications

(16 citation statements)

References 16 publications

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“…The IOL should be placed in the sulcus, rather than in the badly distorted, fibrotic bag and should consider placing scleral sutures otherwise there is risk of the entire bag / lens complex going to the vitreous. Yeh et al, 2002 described use of vitrector to remove fibrotic membrane in CCS [21] As many medical conditions like pseudo exfoliation, uveitis, retinitis pigmentosa, high myopia, myotonic dystrophy, advanced age, diabetes and trauma (including ocular surgery) can predispose patients for development of…”

Section: Discussionmentioning

confidence: 99%

Clinical presentation and management of anterior capsular contraction

Ramnani

Gupta

Ramnani³

2016

Int J Med Res Rev

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Purpose: Aim of this study is to analyze clinical presentation and predisposing risk factors of anterior capsular contraction following phacoemulsification and to assess challenges encountered in management. Methods: This is retrospective study of anterior capsular contractions of capsulorhexis following phacoemulsification. All patients were analyzed for clinical presentation by detail history and slit lamp examination. YAG laser capsulotomy or surgical excision of phimosis was done and various challenges encountered in management were detailed. Results: Total 20 patients (23 eyes), age between 26 years 72 years,, with 13 male and female 7 were analyzed retrospectively. The predisposing risk factors noted were Uveitis (7 patients), myopia (3 patients), pseudo exfoliation (2 patients), diabetes (3 patients), trauma (1 patient), both diabetes and uveitis (1 patient), Status post phacovitrectomy (1 patient) and no accompaniments in (2 patients). We managed 18 patients (21 eyes) by observation in (3 eyes), YAG laser in (7 eyes), simple surgical excisions in (8 eyes), excision with vitrector (1 eye), aspiration of milky fluid behind IOL from bag (1 eye) and phimosed dislocated bag removal from anterior chamber and intraocular lens (IOL) exchange with (SF) scleral fixated IOL (1 eye). Conclusions: Anterior capsular contraction is more common with patients with various risk factors and has varied clinical presentations. Simple procedures like YAG and surgical excision will help patients to restore vision.

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Section: Discussionmentioning

confidence: 99%

Clinical presentation and management of anterior capsular contraction

Ramnani

Gupta

Ramnani³

2016

Int J Med Res Rev

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“…In dense central fibrous plaques, high laser energy may be required, increasing the possibility of postlaser capsulotomy complications. Additionally the free 223 capsular material and debris may lead to inflammation and raised intraocular pressure [5] . Koizumi et al [6] proposed peeling of the fibrous membrane in such cases.…”

Section: Discussionmentioning

confidence: 99%

“…Yeh et al [5] used a vitrector to create a circular capsular opening by removing the fibrosis and releasing the contraction. With this technique all fibrous capsule tissue and residual lens epithelial cells are removed from the anterior chamber, preventing any inflammation or rise in the intraocular pressure secondary to residual debris, decreasing the incidence of recurrence at the same time.…”

Section: Discussionmentioning

confidence: 99%

A New Approach in the Surgical Management of Anterior Capsular Phimosis Syndrome

Panagopoulos¹,

Chalioulias²,

Kirkby³

2009

Ophthalmic Res

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Anterior capsular opacification and contraction syndrome is a well-recognised complication of uneventful phacoemulsification. It often results in a clinically significant reduction in vision secondary to central opacification, intraocular lens decentration and tilt. We report 3 cases of anterior capsular phimosis, which we treated using a new technique, where long, fine pointed scissors are used to cut the anterior capsule radially towards the edge of the lens optic and the edge is then grasped with capsulorrhexis forceps and the anterior capsule is torn away. The tear occurs at the edge of the optic because the anterior and posterior capsules are fused at this point. We believe that our technique offers a superior alternative for the effective, safe and quick management of anterior capsular phimosis, thereby improving the intraoperative fundus view for vitreoretinal surgery or delivery of laser treatment.

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“…Surgical treatment options for ACCS include the use of a capsulorrhexis forceps to peel the fibrotic capsule, 5 microscissors 4 or vitrector-cut capsulotomy. 6 The latter carries the risk IOL damage or severe iris damage, as the tip of the vitrector needs to be pushed towards the IOL to engage the opening of the vitrector with the anterior capsule. We report here a novel, minimally invasive and safe technique of bimanual anterior capsulotomy and haptic reposition or amputation in a small case series to restore a clear visual axis.…”

Section: Introductionmentioning

confidence: 99%

Bimanual anterior segment revision surgery for anterior capsule contraction syndrome associated with anterior flexion of intraocular lens haptics

Zinkernagel

Papazoglou

Patel

2013

Eye

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Purpose To report the incidence of anterior capsule contraction syndrome (ACCS) and to present a novel minimally invasive bimanual technique for anterior segment revision surgery associated with ACCS with anterior flexion of the intraocular lens haptics. Methods A consecutive cohort of 268 eyes of 161 patients undergoing phacoemulsification and implantation of the same type of hydrophilic acrylic aspheric intraocular lens cohort were analysed and a novel technique of minimally invasive bimanual technique for anterior segment revision surgery is described. Results We identified four eyes (1.5%) of three patients with advanced ACCS. Successful restoration of a clear visual axis with minimal induction of astigmatism and rapid visual rehabilitation was achieved in all four cases. Conclusion This technique is a safe and minimally invasive alternative to laser or vitrector-cut capsulotomy to restore a clear visual axis. In cases of advanced ACCS, it offers the option for haptic reposition or amputation.

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Managing anterior capsule contraction by mechanical widening with vitrector-cut capsulotomy

Cited by 29 publications

References 16 publications

Clinical presentation and management of anterior capsular contraction

Clinical presentation and management of anterior capsular contraction

A New Approach in the Surgical Management of Anterior Capsular Phimosis Syndrome

Bimanual anterior segment revision surgery for anterior capsule contraction syndrome associated with anterior flexion of intraocular lens haptics

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