Postoperative Changes Over Time in Size of Anterior Capsulorrhexis in Phacoemulsification/Aspiration

Sugimoto, Yuki; Takayanagi, Katsunori; Tsuzuki, Shosai; Takahashi, Yukio; Akagi, Yoshio

doi:10.1016/s0021-5155(98)00052-5

Cited by 15 publications

(8 citation statements)

References 8 publications

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“…Inadequate coverage of IOL may lead to posterior capsular opacification and change in the effective lens position, 17 whereas an excessively small capsulorhexis may cause anterior capsular contraction. 18 …”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of femtosecond laser-assisted cataract surgery and conventional phacoemulsification in white cataract

Titiyal¹,

Kaur²,

Singh³

et al. 2016

OPTH

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PurposeTo compare femtosecond laser-assisted capsulotomy with conventional manual capsulorhexis in cases of white cataract.Patients and methodsThe prospective comparative study enrolled 80 eyes (80 patients) with white cataract that underwent either femtosecond laser-assisted cataract surgery (Group I, n=40) or conventional manual phacoemulsification (Group II, n=40) at a tertiary care ophthalmic institution. The groups were divided based on the patient’s choice and affordability of the procedure. Capsulotomy/capsulorhexis was evaluated in terms of size, circularity index (4Π [area/perimeter2]), intraocular lens coverage, and continuity. Each group was further subdivided based on the release of white milky fluid on initiation of the capsulotomy/capsulorhexis, and the “fluid” cases were compared with the “no-fluid” cases. The primary outcome measure was capsulotomy/capsulorhexis characteristics in the two groups. The secondary outcome measures were intraoperative phacoemulsification parameters, intraoperative complications, and postoperative visual acuity.ResultsThe size of the capsulotomy/capsulorhexis was 4.9±0.1 mm in Group I and 5.3±0.4 mm in Group II (P<0.001). Mean circularity index was 0.996±0.003 and 0.909±0.047 in Groups I and II, respectively (P<0.001). In Group I, free-floating circular capsulotomies were obtained in 52.5% (21/40) eyes; 37.5% (15/40) eyes had microadhesions; and 10% (4/40) eyes had incomplete capsulotomy in 1–2 clock hours. The incidence of residual adhesions was more in cases with release of white milky fluid (P=0.003). In Group II, a multistep capsulorhexis was performed in 70% (28/40) of the eyes. There was no difference in terms of visual outcomes and intraoperative complications.ConclusionFemtosecond laser-assisted cataract surgery has the advantage of creating a circular and optimally sized capsulotomy in cases of white cataract. The release of white milky fluid during femtosecond laser delivery is the most important factor affecting the creation of a free-floating capsulotomy.

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Section: Discussionmentioning

confidence: 99%

Comparative evaluation of femtosecond laser-assisted cataract surgery and conventional phacoemulsification in white cataract

Titiyal¹,

Kaur²,

Singh³

et al. 2016

OPTH

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“…Anterior capsular contraction occurs most frequently and is most pronounced in patients with silicone-plate IOLs [12]. Risk of developing CCS is more so with small size of capsulorhexis [17] and in high risk cases endocapsular rings (CTR) [18,19] helps in prevention to some extent, though there are reports of developing CCS in spite of CTR [20]. Some time due to extensive fibrosis the CCC opening is rarely visible, these patients can have tilting or decentration and buckling (foldable only) of the IOL.…”

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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“…Also, if the capsulorhexis is too small, it can result in glare, halos, and night driving problems with a diffractive multifocal intraocular lens. Capsular phimosis is more pronounced with small capsulotomies 11,12. A small capsular opening makes surgery more difficult and places greater stress on the anterior capsule during nuclear division or quadrant removal.…”

Section: Discussionmentioning

confidence: 99%

Delineating the extent of anterior capsulorhexis with gentian violet using capsulorhexis marker: a preliminary study of efficacy and toxicity in an animal model

Hassaballa¹,

Osman²

2011

OPTH

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Background:The purpose of this study was to evaluate the efficacy and safety of a new instrument to optimize the size, shape, and centration of anterior capsulorhexis.Methods:The study was divided into two parts. The first part was done in 10 goats’ eyes. A specially designed capsulorhexis marker was used. The lower edge of the instrument was stained by gentian violet and then applied to the anterior capsule to produce a circular mark of 5.5 mm. In five eyes, the gentian violet was applied to the marker using a corneal marking pen; in the remaining five eyes, the gentian violet was applied using a corneal marking pad. In the second part, the toxicity of gentian violet was tested as follows: ten albino rabbits received a gentian violet injection into the anterior chamber in one eye (experimental group) and an equal volume of balanced salt solution in the fellow eye (control group). Five rabbits were sacrificed one day after surgery and the remaining five rabbits after one week.Results:In the first part, there was no difficulty in the introduction or removal of the instrument from all eyes. In the first two eyes, the circular mark was diffuse due to sliding of the marker on the surface of the anterior capsule. In the remaining eight eyes, there was a well-centered, rounded mark which was adequately stained. In the second part, there was no histopathological evidence of corneal toxicity in either group. There was loss of ganglion cells from the neurosensory retina one day after surgery in one eye from the experimental group. At one week, there was no evidence of retinal toxicity in any of the rabbits.Conclusion:This capsulorhexis marker can guide the surgeon to a better centration and proper sizing of anterior capsulorhexis using gentian violet staining. More refinement of the instrument is needed to be able to use it in human eyes.

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Postoperative Changes Over Time in Size of Anterior Capsulorrhexis in Phacoemulsification/Aspiration

Cited by 15 publications

References 8 publications

Comparative evaluation of femtosecond laser-assisted cataract surgery and conventional phacoemulsification in white cataract

Comparative evaluation of femtosecond laser-assisted cataract surgery and conventional phacoemulsification in white cataract

Clinical presentation and management of anterior capsular contraction

Delineating the extent of anterior capsulorhexis with gentian violet using capsulorhexis marker: a preliminary study of efficacy and toxicity in an animal model

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