Reopening the severely contracted lens capsular bag post-phacovitrectomy by injecting OVD and removing the fibrous membranous material

Liu, Yajun; Zhang, Wen; Chen, Feifei; He, Zifang; Xie, Zijian

doi:10.1097/j.jcrs.0000000000000675

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…11 Recently, the blunt separation capsulotomy was reported by Wu et al, Li et al, and Liu et al, in which OVDs were injected into the peripheral space of the capsular bag and the adhesions between the anterior and posterior capsules were bluntly separated. [15][16][17] However, this method may not be suitable for pediatric aphakia with a severe proliferative membrane striding over the anterior and posterior capsulorhexis openings.…”

Section: Discussionmentioning

confidence: 99%

“…14 The second category is the blunt separation capsulotomy, in which ophthalmic viscosurgical devices (OVDs) are used to bluntly separate the adhesion between the anterior and posterior capsules. [15][16][17] Nevertheless, this method may not be suitable for pediatric aphakia with a severe proliferative membrane striding over the anterior and posterior capsulorhexis openings.…”

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Reopening the capsular bag by removing the capsular proliferative membrane to enable secondary in-the-bag IOL implantation in pediatric aphakic eyes

Zhou,

Zhang,

Chen

et al. 2023

J Cataract Refract Surg

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Purpose: To present a surgical technique for reopening the capsular bag in pediatric aphakia. Setting: Zhongshan Ophthalmic Center, Guangzhou, China. Design: Case series study. Methods: Consecutive pediatric bilateral aphakic patients requiring secondary intraocular lens (IOL) implantation between July 2021 and June 2022 were included. The diameter of the capsular proliferative membranous ring (PMR) and position of IOL implantation were documented. Various parameters of capsular opening during primary cataract removal and secondary surgery were also analyzed. Results: Forty-eight eyes were included with a mean follow-up of 8.1±4.4 months. Using surgical technique developed here, the capsular bag was successfully reopened with in-the-bag (ITB) implantation in 43 eyes (89.6%). ITB implantation was accomplished in all eyes with an outer diameter of PMR≤5.5 mm, and in 3 of 8 eyes (37.5%) with an outer diameter of PMR>5.5 mm. A positive correlation was observed between the primary and secondary anterior capsular opening diameters (ACOD) (r=0.422, P=0.007) and the primary and secondary posterior capsular opening diameters (PCOD) (r=0.619, P<0.001). The inner diameter of PMR was found to be positively correlated with secondary PCOD (r=0.728, P<0.001), and the outer diameter with secondary ACOD (r=0.669, P<0.001). Conclusions: This is a safe and effective surgical technique for pediatric secondary IOL implantation with maximum preservation of the peripheral capsule. Aphakic eyes with an outer diameter of PMR≤5.5 mm are preferred for secondary ITB implantation.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Reopening the capsular bag by removing the capsular proliferative membrane to enable secondary in-the-bag IOL implantation in pediatric aphakic eyes

Zhou,

Zhang,

Chen

et al. 2023

J Cataract Refract Surg

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Reopening the severely contracted lens capsular bag post phaco-vitrectomy by mini anterior peripheral capsulorhexis and visco-dissection

Jiang,

Zhang,

Chen

et al. 2024

Indian Journal of Ophthalmology - Case Reports

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To introduce a novel technique for reopening the capsular bag with severe fibrosis for aphakic patients after primary phaco-vitrectomy. Ocular viscosurgical device (OVD) was injected into the anterior chamber. An area of the anterior capsule was identified where the fibrosis was less severe and therefore left a wider healthy peripheral capsule. A cystitome was used to perforate the anterior capsule near the anterior capsular margin, and care was taken not to injure the posterior capsule below. The mini anterior capsulorhexis was then performed with capsular forceps, approximately 2 mm in diameter. A blunt cannula was used to slightly separate the anterior and posterior capsule right at the mini capsulorhexis. OVD was then injected slowly and continuously through the mini-opening to separate the two layers until the capsular bag was completely reopened. A foldable IOL was implanted into the capsular bag. Four consecutive cases (4 eyes) were enrolled in this study. All the fibrotic capsular bags in four eyes were reopened by mini anterior peripheral capsulorhexis combined with visco-dissection. Secondary in-the-bag IOL implantation was carried out smoothly. Conclusion: This novel surgical technique is safe and effective in reopening the capsular bag with severe fibrosis after primary phaco-vitrectomy.

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Reopening the severely contracted lens capsular bag post-phacovitrectomy by injecting OVD and removing the fibrous membranous material

Cited by 2 publications

References 12 publications

Reopening the capsular bag by removing the capsular proliferative membrane to enable secondary in-the-bag IOL implantation in pediatric aphakic eyes

Reopening the capsular bag by removing the capsular proliferative membrane to enable secondary in-the-bag IOL implantation in pediatric aphakic eyes

Reopening the severely contracted lens capsular bag post phaco-vitrectomy by mini anterior peripheral capsulorhexis and visco-dissection

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