Mechanical detachment of the anterior hyaloid membrane from the posterior lens capsule

Torii, Hideo; Takahashi, Keizo; Yoshitomi, Fumiaki; Ishíi, Yasuo; Oshika, Tetsuro

doi:10.1016/s0161-6420(01)00819-3

Cited by 20 publications

(19 citation statements)

References 10 publications

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“…[3][4][5] However, in humans, this procedure has been reported to cause posterior capsule rupture, 6 lens nucleus dislocation, 7 and detachment of the AHM. 8 Rapid fluctuations in the IOP or elevated perfusion pressure during hydrodissection might cause AHM detachment or tears. 1 The magnitude of increased IOP during hydrodissection is strongly influenced by the characteristics of the ophthalmic viscosurgical device (OVD) filling the anterior chamber (AC).…”

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confidence: 99%

Influence of Elevated Intraocular Pressure on the Posterior Chamber–Anterior Hyaloid Membrane Barrier During Cataract Operations

Kawasaki

Tasaka²,

Suzuki³

et al. 2011

Arch Ophthalmol

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To investigate the influence of elevated intraocular pressure on the posterior chamber-anterior hyaloid membrane (PC-AHM) barrier during cataract operations in ex vivo porcine eyes. Methods: A pressure transducer was connected to porcine eye anterior chambers (ACs). In experiment 1, ACs were perfused for 20 seconds with balanced salt solution containing 1.0-µm fluorescein beads (10 eyes per bottle height: 45, 85, 145, and 285 cm). In experiment 2, 5 ophthalmic viscosurgical devices with different molecular weights and sodium hyaluronate concentrations were infused into the ACs (20 eyes per ophthalmic viscosurgical device). After continuous curvilinear capsulorrhexis, hydrodissection was performed. After both experiments, PC-AHM barrier staining was evaluated through the Miyake-Apple view. Results: Types of fluorescein staining patterns were classified as AC, zonule of Zinn, AHM, AHM tear, and ruptured capsule. In experiment 1, plateau intraocular pressure and staining type were positively correlated (Spearman rank correlation; r=0.703, P Ͻ.001). In experiment 2, mean peak intraocular pressure was significantly greater in the ruptured capsule-type eyes than in the AC-, zonule of Zinn-, AHM (P Ͻ .001), or AHMtear-(P=.02) type eyes, as well as in the AHM-and AHMtear-type eyes compared with the AC and zonule of Zinn type eyes (P Ͻ .001). Intraocular pressure was significantly higher in eyes infused with ophthalmic viscosurgical devices with a higher molecular weight or sodium hyaluronate concentration (P Ͻ.05). Conclusions: Stress on the PC-AHM barrier increases as intraocular pressure increases. Ophthalmic viscosurgical devices with a higher molecular weight or sodium hyaluronate concentration might induce increased IOP during cataract operations. Clinical Relevance: To maintain normal PC-AHM barrier function, excessive intraocular pressure should be avoided during cataract operations.

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confidence: 99%

Influence of Elevated Intraocular Pressure on the Posterior Chamber–Anterior Hyaloid Membrane Barrier During Cataract Operations

Kawasaki

Tasaka²,

Suzuki³

et al. 2011

Arch Ophthalmol

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“…In order to benefit from the visualization of the AVB provided by high-magnification and tangential endoscopic viewing for treating - and preventing - both anterior-posterior and circumferential loops of contracted gel, it is necessary to achieve two different actions: (1) to disconnect the adhesion of the AVB's anterior part from the capsulozonular system and from the ciliary epithelium (hyaloidocapsulozonular dissection) [38], and (2) to break the depth of the gel tissue inside the AVB's anterior and posterior parts until the roots of their adhesions on the ciliary-retinal surfaces (fig. 6).…”

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confidence: 99%

Endoscopic Evaluation and Dissection of the Anterior Vitreous Base

Boscher

Kuhn

2015

Ophthalmic Res

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The specific concept of pathological anterior vitreous base (AVB) and of its endoscopy-assisted dissection was elaborated during our 20 years' experience with endoscopy for observing the ‘in vivo' anatomy and pathoanatomy of the AVB, and for dissecting the anterior vitreous cortex in over 2,000 consecutive eyes. Endoscopy provides a 360° view of the entire vitreous cavity akin to the surgeon's eye being inside the operated eye. Evaluation of the capsulozonular complex, ciliary body, and AVB is not only independent of anterior media transparency, but unimpeded by scleral depression and magnified. High magnification dissection of the AVB gel can be conducted in an individualized and unmatched fashion.

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“…As hypothesized earlier, a break in the ligament of Weiger is the only way in which pigment can reach the space of Berger. Since cases of spontaneous breaks in the ligament of Weiger are rare, 16 we propose another mechanism for this break. Bernal et al 17 were able to describe and document the precise insertion of the anterior and posterior zonules to the lens capsule.…”

Section: Discussionmentioning

confidence: 97%

Curvilinear, symmetrical, and profound pigment deposition on the posterior lens capsule in a patient with bilateral pigmentary dispersion syndrome

Canestraro¹,

Sherman²

2018

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IntroductionThe classic presentation of pigmentary dispersion syndrome (PDS) often consists of midperipheral iris transillumination defects, Krukenberg’s spindle, and dense homogeneous trabecular pigmentation. Other subtle, sometimes overlooked features include pigment on the lens zonules, pigment on the anterior lens capsule and pigment along the equator of the posterior lens capsule.CaseThis unique presentation of PDS presented with bilateral, dense, oblique, and symmetrical pigment deposition along the posterior lens capsule that changed in shape, density, and extent over the span of 3 years.DiscussionThere have been few reports in the literature that describe a central accumulation of pigment along the posterior lens capsule associated with PDS. There are reported cases of pigment deposition along the central aspect of the posterior lens capsule, some changing over time, although none were bilateral and symmetrical. There are suggestions that perhaps this central pigment deposition is related to a break in the ligament of Weiger, allowing communication between the posterior chamber and posterior lens capsule. This is a case in which curvilinear, symmetrical, and changing pigment deposition on the posterior lens capsule is suggestive of perhaps another key features of PDS.

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Mechanical detachment of the anterior hyaloid membrane from the posterior lens capsule

Cited by 20 publications

References 10 publications

Influence of Elevated Intraocular Pressure on the Posterior Chamber–Anterior Hyaloid Membrane Barrier During Cataract Operations

Influence of Elevated Intraocular Pressure on the Posterior Chamber–Anterior Hyaloid Membrane Barrier During Cataract Operations

Endoscopic Evaluation and Dissection of the Anterior Vitreous Base

Curvilinear, symmetrical, and profound pigment deposition on the posterior lens capsule in a patient with bilateral pigmentary dispersion syndrome

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