Reduction in the Area of the Anterior Capsular Opening A fter Ac ryl Intraocular Lens Implantation: Diabetics vs Nondiabetics

We compared the rate of continuous curvilinear capsulorhexis[CCC]con traction and degree of postoperative capsular fibrosis between patients with non-proliferative diabetic retinopathy and age-matched non-diabetic patients after phacoemulsification with posterior chamber acryl foldable intraocular lens implantation.Sixty-two eyes of 42 patients of non-proliferative diabetic retinopathy and 78 eyes of 55 patients of control group who underwent cataract surgery with acryl foldable intraocular lens were enrolled in this retrospective study.During follow up examination the rate of CCC contractions were evaluated by NIDEK EAS-1000 System and we measured the area of anterior capsular opening.The diabetic patients average percentage of anterior capsular shirinkage rate was higher than non-diabetic patient's. But no statistically significant difference was found between the two groups. In conclusion, small incision cataract surgery with acryl foldable intraocular lens implantation showed good results in diabetic patients.Further studies will be needed for better clinical safety and efficacy.

Quantitative Analysis of Anterior Capsule Opening after PMMA, Silicone and Acrylic Intraocular Lens Implantation

To quantify the periodic changes in the area of anterior capsule opening after cataract surgery and to compare any difference between polymethylmethacrylate (PMMA), silicone and soft acrylic IOLs, we prospectively studied 442 patients (465 eyes)who were operated from September 1997 to November 1999 at our hospital.All patients had standardized phacoemulsification, continuous curvilinear capsulorhexis, and intraocular lens implantation performed by the same surgeon.Patients were randomized into three groups based on the type of intraocular lens.The area of anterior capsule opening was quantitated using the Anterior Eye Segment Analysis System (EAS-1000), and examinations were performed at 1 week and 1, 3 and 6 months after surgery.The mean anterior capsular opening area at 1, 3 and 6 months postoperatively was smaller than that of 1 week in all 3 groups (P<.05)and the mean percentage of reduction in the PMMA and soft acrylic intraocular lens groups was significantly smaller than that in the silicone intraocular lens group at 1, 3 and 6 months after surgery (P<.05).In the silicone group, the contraction of the anterior capsule opening was greater than either PMMA or soft acrylic intraocular lens groups.Further studies will be needed for the evaluation of clinical application of silicone and soft acrylic intraocular lens.

Comparison of Anterior Capsule Opening after Silicone Intraocular Lens Implantation with and without Capsular Tension Ring

To evaluate the effect of capsular tension ring on prevention of capsular opening reduction induced by CCC in Phacoemulsification with silicone intraocular lens implantation, we prospectively studied 60 patients (60 eyes)who were operated from Sept, 1997 to Jun, 1998 at our hospital.All patients had standardized Phacoemulsification, continuous curvilinear capsulorhexis, and intraocular lens implantation performed by the same surgeon.Patients were randomized into two groups based on capsular tension ring insertion.We compared uncorrected visual acuity (UCVA), spherical equivalent (SE), astigmatism and the data obtained by the Anterior Eye Segment Analysis System (EAS-1000), anterior chamber depth, IOL tilting, decenteration, and anterior capsule opening area at 1 week and 1, 3, 6 months after surgery.Two groups showed a similar pattern of change of UCVA, SE and astigmatism. There are no statistical significances in comparison of anterior chamber depth and IOL decenteration in two groups, but IOL tilting of group II is greater than that of group I at 6 months after surgery.The mean anterior capsular opening area at 1, 3, 6 months postoperatively was smaller than that of 1 week in two groups, but no statistical significances were observed in group II (1, 3, 6 months, P = or > .05).The mean percentage reduction of group I was significantly smaller than that of group II at 3 and 6 months (P<.05)after surgery.Capsular tension ring might prevent a contraction of capsular opening and might enhance the stability of IOL.

Implantable Contact Lens to Correct High Myopia(Clinical Study with 24 Months Follow-up)

A ICL TM(STAAR Collamer Posterior chamber Implantable Contact Lens) lents ranging from -11D to -21.3D. And then we investigated the visualwas implanted in 12 eyes of 7 patients with preoperative spherical equivalents ranging from -11 D to -21.3 D. And then we investigated the visual acuity, mean endothelial cell loss, change of refractive error and postoperative complications.Average follow-up was 28.1 months. In the immediate postoperative days, all eyes had a significant increase in uncorrected visual acuity and the best corrected visual acuity was improved in 7 eyes(58.3%). Mean percent difference between preoperative and postoperative endothelial cell count was 3.22+/-0.05% . The mean preoperative spherical equivalent refraction was -15.65+/-2.78 D. At a mean follow-up of 1 month, mean spherical equivalent refraction was -1.67+/-0.72D, at a 6months, 12 months, 24 months, mean spherical equivalent refraction was each -1.56+/-0.72D, -1.63+/-0.68D, -1.73+/-0.76D. During follow-up days one eye developed an faint anterior subcapsular cataract but the patient remained symptom free. Other reported complication was transient increased intraocular pressure. Although the follow-up in our study was limited cases(12 eyes), from our experience, the posterior chamber implantable contact lens was efficacious and safe in the correction of high myopic refraction errors.

Three Cases of Iridoeorneal Endothelial Syndrome

Iridocorneal endothelial syndrome is a disease characterized by corneal endothelial degeneration, corneal edema, peripheral anterior synechia, iris stromal change, and secondary glaucoma. This syndrome is considered to have three major variations: Chandler's syndrome, progressive (essential) iris atrophy, and Cogan-Reese syndrome. We experienced three cases of iridocorneal endothelial syndrome with transient intraocular pressure elevation.

Morphological Studies on the Rabbits Ciliary Epithelium by Apraclonidine

Apraclonidine is a potent alpha-adrenergic agonist that, like clonidine, is relatively selective for alpha-2 receptors. Apraclonidine has been shown to lower intraocular pressure by diminishing aqueous humor formation. The purpose of this study is to know the morphological changes in the ciliary epithelium by apraclonidine against aqueous formation. In group I, two drops of 1% apraclonidine hydrochloride were instilled on the right eye of the pigmented rabbits and the eyes were enucleated on 1,2.6 and 24 hours after instillation to find out the duration of action of the drug and the tissue response. In group II, one drop was instilled twice daily for seven days on the right eye and the eyes were enucleated on 1, 2 and 5 days after cessation of the instillation observing the cumulative effect of the drug and the tissue response. These eyes were studied with electron mIcroscopIc examiation. As a result, widening of cell membranes(basal infoldings) of the non-pigmented epithelium(NPE) were observed. This change was recovered with time, and seems to be the principal morphological changes of apraclonidine against aqueous formation in the ciliary body. In group II, the cellular changes were minimal except for well developed rough endoplasmic reticulum representing resumed secretary function of the cell.