ABSTRACT
Small perforations are often managed with cyanoacrylate glue - bandage contact lens (BCL). An additional layer with substances like sterile drape often enhances the strength of the glue. Herein, we describe a novel method of using anterior lens capsule as biological drape to secure perforation. The anterior capsule was secured from femtosecond laser–assisted cataract surgery (FLACS) and placed over the perforation after folding it twice. The area was dried and a small aliquot of cyanoacrylate glue was applied over it. The BCL was applied over it after the glue was dry. In our series of five patients, none of them needed repeat surgery and all cases healed by three months without vascularization. It is a unique technique to secure small corneal perforations.
ABSTRACT
Se presenta el caso de una mujer de 81 años que acude para valoración de cirugía de catarata en el ojo derecho. El examen biomicroscópico revela la existencia de una catarata C2N4 (Lens Opacities Classifi cation System, versión III) con una cápsula anterior que en su región central pareciera estar abierta a modo de capsulorrexis, aunque sin trasvase de material lenticular ni signos inflamatorios en cámara anterior Figura 1. Su consistencia y morfología nos hacen pensar en un posible desdoblamiento idiopático de la cristaloides anterior, ya que tanto el reborde pupilar como la gonioscopia son rigurosamente normales. De ahí nuestro título de "pseudocapsulorrexis".
Subject(s)
Capsulorhexis , Cataract Extraction , Lens, Crystalline/diagnostic imagingABSTRACT
PURPOSE: To compare the anterior capsule contraction and intraocular lens (IOL) decentration among three types of IOL to determine the influence of haptic design on anterior capsule stability. METHODS: One hundred fifty patients were enrolled in this prospective, randomized study and 260 eyes underwent implantation of one of the following IOLs: modified L-haptic IOL (n = 74), modified C-haptic IOL (n = 97), or a plate-haptic IOL (n = 89). The area of the anterior capsule opening, IOL decentration, and capsule overlap were measured using retroillumination photospot 1 day and 2 months after cataract surgery. RESULTS: The area of capsule opening at postoperative day 1 was significantly different between the three IOLs (p < 0.01). All IOLs showed reduction of the anterior capsule opening from 1 day to 2 months after surgery, and greater reduction was shown in the modified C-haptic IOL (p < 0.001). At postoperative month 2, IOL decentration was significantly different between the IOLs and showed a positive correlation with the mean area reduction during month 2. CONCLUSIONS: The degree of anterior capsule contraction and IOL decentration in modified L-haptic IOLs were less than those in modified C-haptic IOLs and comparable to those in plate-haptic IOLs.
Subject(s)
Humans , Cataract , Lenses, Intraocular , Prospective StudiesABSTRACT
To investigate the curative effect of retaining the peripheral anterior lens capsule combined lensectomy with vitrectomy for ocular trauma. ●METHODS: Totally 33 patients ( 33 eyes ) with eye trauma underwent combined lensectomy with vitrectomy, retaining the peripheral anterior lens capsule and phase Ⅱposterior chamber lOL implantation. After follow - up of 6mo, visual acuity, intraocular pressure ( lOP ), lOL position, and intraoperative and postoperative complications were observed. ●RESULTS: Visions of all the patients were improved at varying degrees. After follow-up of 6mo, no obvious lens deflected and serious complications ( glaucoma, retinal detachment) appeared. ●CONCLUSlON: Combined lensectomy with vitrectomy, retaining the peripheral anterior lens capsule for ocular trauma has good curative effects of lessening complications during operation and postoperation and good visual acuity recovery.
ABSTRACT
· AIM: This study was designed to evaluate the effectiveness of anterior lens capsule inclusion in combined trabeculectomy and cataract surgery in preventing scar formation of the filtering bleb in rabbit model.· METHODS: Twerty-Four eyes (12 rabbits) with glaucoma model were studied, anterior lens capsule inclusion in trabeculectomy with the small-incision cataract surgery were performed on all right eyes (experimental group) and no implants were applicator in trabeculectomy with the small-incision cataract surgery on all left eyes (control group). These operated eyes were followed up from day 1 to 6 months postoperatively. Intraocular pressure (IOP) was measured and filtering blebs were observed after surgery. Other main outcome measures: cornea、conjunctiva、formation of the anterior chamber, anterior chamber depth、inflammatory reaction、achievement ratio of operation and complications were analyzed. On week 1, 2, 4, 12 and 24 after surgery the animal were killed in batch. Tissue was harvested from the bleb area and was made pathological section. HE staining、light microscope and micro photo analysis technique were applied to observe the cytological and histopathologic characteristics of the filtering tunnels.· RESULTS: There were significant differences between the two groups on IOP (1, 2, 4 weeks)、filtration bleb, achievement ratio of operation and complications. In experimental group, at the first month postoperatively, anterior lens capsule absorption started with inflammatory characteristics. The peak of inflammatory reaction occurred 1 week after operation and all the cells in the filtrating tunnel disappeared 6month after surgery. The fibroblast proliferation in control group occurred at I week and the filtrating tunnel closed with angiogenesis at 1 month after surgery. Fibroblast proliferation started 1week after surgery with no statistical difference during the time course (P ＞0.05). Significant statistical differences were observed by comparing the fibro blasts numbers per unit area in the filtrating tunnel in experimental group and those in control groups (P＜0.05).· CONCLUSION: Anterior lens capsule was totally absorbed at 6 months postoperatively. Anterior lens capsule inclusion in trabeculectomy with cataract surgery can possibly control intraocular pressure effectively, long-term sustainability of functional filtration bleb, inhibition of the proliferation of fibroblasts and opening of the filtrating pathway in the experimental animal models were satisfied. Compared to the control group, anterior lens capsule application has less complication.
ABSTRACT
Objective To evaluate the effects on trabeculectomy combined with implantation of anterior lens capsule.Design Radomized,controlled experimental study.Participants 36 experimental albino rabbits.Methods 36 albino rabbits were divided into 3 groups randomly.The rabbit and human anterior lens capsules were implanted under the scleral flap in trabeculectomy in group A and group B respectively,while only trabeculectomy in control group.The average follow-up period was 12 months.Main Outcome Mea- sures Intraocular pressures(IOP),filtering bleb,complications.Results The postoperative IOP of the experimental groups decreased sig- nificantly as compared with preoperative IOP at 12 week postoperatively.Retention of reflective filtering bleb in experimental groups was longer than that in contral group(5.12?0.43week,5.05?0.59week,2.74?0.32week,P＜0.05).The passage of humor outflow kept open in ex- perimental groups and became closed in control group at 12 week postoperatively.Anterior lens capsule wasn't attacked by T or B lym- phocyte seen with electron microscope.Conclusions Implantation of anterior lens capsule may help to postpone filtering bleb scarring in the trabeculectomy.This study provides experimental basis for the clinical practice.