Management of late-onset flocculent after-cataract with capsular bag lavage and posterior continuous curvilinear capsulorhexis

We describe our technique for the management of late-onset liquefied after-cataract (LAC) to ensure long-term visual axis clarity. The densely adherent anterior capsular rim over the intraocular lens (IOL) optic was released with the help of microvitreoretinal blade, and multiple relaxing radial incisions were made on the capsular rim to facilitate easy access to the capsular bag. A thorough capsular bag lavage was performed with the help of bimanual irrigation-aspiration. Posterior continuous curvilinear capsulorhexis (PCCC) was performed after complete aspiration of fluid after-cataract to prevent recurrence. This technique was successfully performed in 14 cases. Postoperatively, IOL was stable and an uncorrected distance visual acuity of >20/32 was achieved in all cases. No recurrence was observed in any case over a follow-up of 1 year. Our technique of capsular bag lavage with PCCC is safe and effective for the management of LAC with optimal visual and anatomical outcomes.

Clinical effect of anterior vitrectomy for congenital cataract / 国际眼科杂志(Guoji Yanke Zazhi)

?AlM: To evaluate the clinical efficacy of posterior continuous curvilinear capsulorhexis ( PCCC ) combined with anterior vitrectomy in preventing posterior capsule opacification of congenital cataract surgery. ?METHODS:Postoperative clinical follow-up data of 82 cases ( 87 eyes ) with congenital cataract treated in Eye Center of our hospital from January 2011 to August 2014 were retrospectively analyzed. The patients were divided into the surgical control group ( 38 cases, 40 eyes, recieved phacoemulsification + PCCC ) and the study group ( 44 cases, 47 eyes, accepted phacoemulsification+ PCCC + anterior vitrectomy). The incidence of central optic axis opaque and postoperative visual acuity distribution were recorded at 1a follow - up. lntraoperative and postoperative complications were observed. ?RESULTS:The rate of central optic axis opaque grade 0 in control group was 37. 5%, compared to 76. 6% in study groups. The opacity distribution ratio of grade 1,2,3 and 4 in study group were lower than that of control group, and the central optic axis opacity distribution ratio in study group was significantly better than that of control group (P0. 5 in control group was lower than the 40 eyes ( 85. 11%) of that in study group. The visual acuity between two groups has statistical significance difference after 1a follow-up ( P ?CONCLUSlON: Combination of phacoemulsification, PCCC and anterior vitrectomy presents reliable clinical effects on postoperative central optic axis opacity distribution ratio and visual acuity, and it should be adopted to prevent the occurrence of posterior capsule opacification.

Clinical application of posterior continuous curvilinear capsulorhexis of posterior capsular rupture in the phacoemulsification / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract? AlM: To observe the clinical effect of posterior continuous curvilinear capsulorhexis ( PCCC ) in phacoemulsification with posterior capsular rupture.?METHODS: Thrity-eight age-related cataract patients (38 eyes) from March 2013 to October 2013 were selected as experimental group and 50 age - related cataract patients ( 50 eyes ) from March 2013 to October 2013 as control group. ln experimental group, PCCC were used in the intraoperative posterior capsule tears in phacoemulsification. And in control group phacoemulsification was applied. The visual acuity and surgical complications were compared between two groups, the follow-up period was continued to 3mo after operation.?RESULTS: The visual acuity and corneal edema in two groups had statistically significant ( P 0. 05 ). At 1d after operation, the intraocular pressure in two groups was not statistically significant (P>0. 05). Three months after operation, the pupil and cystoid macular edema, retinal detachment in two groups was not statistically significant (P>0. 05).?CONCLUSlON:PCCC can improve the therapeutic effect and prevent surgical complications for phacoemulsification with posterior capsular rupture.

Surgical Techniques and Postoperative Complications in Pediatric Cataract Surgery

PURPOSE: To evaluate postoperative complications of different surgical techniques in pediatric cataract. METHODS: We retrospectively reviewed 105 eyes of 72 patients who had undergone irrigation and aspiration of cataracts with posterior chamber intraocular lens (IOL) implantation from January 1994 to June 2004. All the eyes were divided into three groups according to the surgical techniques used: group 1 (n=39), IOLs in the bag + intact posterior capsule; group 2 (n=24), IOLs in the bag + posterior continuous curvilinear capsulorhexis (PCCC) + anterior vitrectomy; group 3 (n=42), IOLs in the bag + PCCC + optic capture. Postoperative posterior capsular opacity (PCO), secondary intervention for PCO, strabismus, inflammation, glaucoma, vitreoretinal complications were evaluated. RESULTS: Different from those in the past, current surgical methods for pediatric cataract entail either the optic capture of IOL or anterior vitrectomy through PCCC. PCO is the most frequent postoperative complication. Thirty-five eyes (87.1%) in group 1, 2 eyes (8.3%) in group 2, and no eyes in group 3 developed PCO. Five eyes (33.3%) had recurrence of PCO when PCO was treated by Nd:YAG laser posterior capsulotomy. None had PCO recurrence with secondary optic capture of IOL. Postoperative inflammation and IOL decentration were more common in group 2 than in the other groups. There was no statistically significant difference in the prevalence of postoperative glaucoma between the groups. Neither vitreoretinal complication nor infection was found in our series. CONCLUSIONS: Optic capturing of IOL through PCCC permanently maintains the visual axis with the anterior vitreous face preserved.

Phacoemulsification Combined with Transpupillary Silicone Oil Removal Through Posterior Continuous Curvilinear Capsulorhexis

Silicone oil has been used successfully in vitreoretinal surgery for many years. But complications from the use of silicone oil as a long-acting internal tamponade may develop. They include glaucoma, keratopathy, oil emulsification, and cataract. For patients requiring silicone oil removal and cataract surgery, both operations can be performed in a combined procedure. After phacoemulsification, a posterior continuous curvilinear capsulorhexis(PCCC) is performed, followed by irrigation of balanced salt solution(BSS)into vitreous cavity allowing flow out of silicone oil through the PCCC and intraocular lens(IOL)is implanted into remaining capsular bag. This technique offers faster visual rehabilitation, shorter operation time and reduces the risk of peripheral retinal defect, vitreous hemorrhage that may be caused by traditional oil removal through sclerostomy.

Influence of the phacoemulsification with posterior continuous curvilinear capsulorhexis and anterior vitrectomy on after cataract:a Meta-analysis / 眼科

Objective To evaluate the functional outcomes of the phacoemulsification(Phaco)with posterior continuous curvilinear capsulorhexis(PCCC),or with PCCC and anterior vitrectomy(AV)on after cataract.Design Meta analysis based on the reference searching.Participants A comprehensive electric search in MEDLINE,CNKI,CBMdisc,VIP information,CMCC,CCPD,SSreader,21dmedia and a manual search in related textbooks,journals,congress articles and their references in English and Chinese.Methods Strictly include and exclude the relevant articles from the resource with statistical criterion and get the needing data.Statistically analysed the data with software of Review Manager4.2.2,SPSS10.0.Heterogeneity of the included articles was tested that used to select appropriate effect model to Meta-analysis.Treatment effect was measured as odds ratio between Phaco with PCCC group and Phaco with PCCC+AV group.Change the selected effect model and calculate the fail-safe number(Nfs)to assess the sensitivity and specificity of the research.Main Outcome Measures Sensitivity,heterogeneity,the according confidence intervals(CI)and Nfs.Results Six studies were included,with a sum of 305 eyes.With the outcomes of heterogeneity test,the fixed effect model was used in both groups to calculate OR.The pooled OR of after cataract was 0.13(95%CI is 0.06-0.25).Sensitivity analysis demonstrated that no disproportionate influences of individual study.And Nfs=76.8,the result was confirmed.Conclusion Phacoemulsification with posterior continuous curvilinear capsulorhexis and anterior vitrectomy is superior to phacoemulsification with posterior continuous curvilinear capsulorhexis on preventing after cataract.