Changes of Preoperative and Postoperative Anterior Chamber Depth in Phacoemulsification and Planned Extracapsular Cataract Extraction

To compare the preoperative and postoperative anterior chamber depths in cataract surgery, we performed phacoemulsification followed by posterior chamber intraocular lens(PCIOLs) implantation on 20 eyes(Group I) and planned extracapsular cataract extraction(p-ECCE) followed by PCIOLs implantation on 20 eyes(Group II). After that, we measured prospectively the preoperative anterior chamber (AC) depths and postoperative AC depths 1, 3, 7, 30 and 60 days by using a Scheimpflug camera. The preoperative mean values of AC depths were 2.93mm in Group I and 2.71mm in Group II. In Group I, the postoperative AC depth was increased significantly compared to preoperative AC depth and the difference between preoperative and postoperative AC depth was maintained from the first day of measurement to day 60(p<0.001). In Group II, AC depth of the postoperative day 1 was significantly increased compared to the preoperative depth(p<0.001), but it was slightly decreased at postoperative day 30(p=0.002) and day 60(p=0.02). And there were no significant differences between Group I and Group II in changed of AC depth. The result implies that AC depth was increased significantly after both phacoemulsification and p-ECCE.

Comparision of Surgically Induced Astigmatism between Superior and Temporal Scleral Incision in Planned Extracapsular Cataract Extraction

Astigmatic change in planned extracapsular cataract extraction (P-ECCE) using temporal scleral incision (n=25 eyes) was compared for 2 months with that using superior scleral incision(n=19 eyes), retrospectively. The astigmatic change was analyzed using Naeser`s polar value. Surgically induced astigmatism induced by temporal scleral incision was 0.96+/-1.38D of with the rule(WTR), 2.35+/-1.36D (WTR), and 2.45+/-1.24(WTR) at 3 days, 2 weeks, and 2 months, respectively. In contrast, that induced by superior scleral incision was 2.29+/-2.30D(WTR), 0.76+/-2.39(WTR)and -0.95+/-1.88D of against the rule(ATR) at 3 days, 2 weeks, and 2 months, respectively. In another words, temporal scleral incision in P-ECCE induced WTR astigmatism as early as postoperative 3 days that incerased by 2 weeks and stabilized after 2 weeks, whereas superior scleral incision in P-ECCE induced a prominent WTR astigmatism as early as postoperative 3 days, that was converted to ATR astigmatism from 1 month and increased the change by 2 months. With this result, it was found that most cataract patients existing ATR astigmatism would be candidates for temporal incision in P-ECCE.

Extraction of the Leris Nucleus with the Continuous Circular Capsulorhexis in Planned Extracapsular Cataract Extraction

We rotated the nucleus up to 270 degree and dislocated it into anterior chamber through the diameter of capsulorhexis after hydrodissection by using the planned extracapsular cataract extraction. And later on we delivered the nucleus with hydroexpression using the irrigating Vectis or with rotation using a lens spatuala. As a result of this procedure, the nucleus was safely delivered in all cases without zonular rupture and vitreous prolapse.