Effect of Haptic Material and Number of Intraocular Lens on Anterior Capsule Contraction after Cataract Surgery

PURPOSE: To evaluate changes over time of the anterior capsule opening size after phacoemulsification, based on haptic number and composition of three acrylic intraocular lenses (IOLs). METHODS: Fifty-five patients (70 eyes) were included. All underwent phacoemulsification followed by implantation of either an acrylic IOL with two-haptic (one-piece, 26 eyes; three-piece, 22 eyes), or four-haptic (one-piece, 22 eyes). The area of the anterior capsule opening size was measured one week postoperatively (baseline) and at three months. RESULTS: There was a significant reduction in the area of the anterior capsule opening from one week as compared to three months postoperatively in all groups (p < 0.001). However, there was no significant difference in the reduction in the anterior capsule opening between the IOLs (p = 0.36). CONCLUSIONS: The number and material of the haptic of the three acrylic IOLs did not influence the degree of anterior capsule opening shrinkage.

Correlación entre la localización del lente intraocular, según biomicroscopia ultrasónica,y diferentes parámetros quirúrgicos en pacientes operados de catarata / Correlation between the location of the intraocular lens according to ultrasonic biomicroscopy and several surgical parameters in patients operated from cataract

OBJETIVO: Determinar la correlación entre la localización del lente intraocular en cámara posterior por biomicroscopia ultrasónica, diferentes parámetros quirúrgicos en pacientes operados de catarata. MÉTODOS: Se realizó un estudio descriptivo, prospectivo y transversal en el Instituto Cubano de Oftalmología Ramón Pando Ferrer durante el período de enero a junio del 2007. Se estudiaron variables como: edad, sexo, etiología de la catarata, técnica quirúrgica, localización del lente intraocular según biomicroscopia ultrasónica, así como complicaciones transoperatorias y posoperatorias. RESULTADOS: El 79 por ciento de todos los pacientes operados tenían entre 60 y 79 años de edad y algo más de la mitad correspondió al sexo femenino con un 59 por ciento. La catarata senil fue la etiología que predominó con un 74 por ciento y en el 68 por ciento de los casos el lente se localizó por biomicroscopia ultrasónica en el saco capsular. En los ojos donde el lente intraocular se localizó fuera del saco, la proporción de complicaciones transoperatorias y posoperatorias fueron significativamente mayoritarias, mientras que en los ojos donde el lente intraocular se encontraba en el saco, la mayoría no presentó complicaciones transoperatorias ni posoperatorias. CONCLUSIONES: Las diferencias entre las distintas localizaciones del lente intraocular se encontraron con significación estadística en el tipo de catarata, la presencia de complicaciones transoperatorias y posoperatorias, sin embargo, no se encontró relación estadística significativa entre la localización del lente intraocular con la técnica quirúrgica utilizada

OBJECTIVE: To determine the correlation between the location of the intraocular lens in the posterior chamber using ultrasonic biomicroscopy and the different surgical parameters in patients operated from cataract. METHODS: A prospective, descriptive and cross-sectional study was carried out in Ramón Pando Ferrer Cuban Institute of Ophthalmology in the period of January to June 2007. The studied variables were age, sex, etiology of cataracts, surgical technique, location of the intraocular lens using ultrasonic biomicroscopy, as well as transoperative and postoperative complications. RESULTS: Seventy nine percent of all the surgical patients were 60-79 years of age and 59 percent were females. The senile cataract was the prevailing etiology for 74 percent and the lens was located in the capsular sac using ultrasonic biomicroscopy in 68 percent of the cases. In those eyes where the intraocular lens was off the sac, the ratio of transoperative and postoperative complications was significantly higher, whereas most of the eyes with the IOL placed in the sac did not have either transoperative or postoperative complications. CONCLUSIONS: The differences between the different locations of the intraocular lens were statistically significant in terms of the type of cataract; however, there was not any significant statistical association between the location of the intraocular lens and the surgical technique

Avaliação do uso do anel endocapsular modificado em casos de subluxação traumática do cristalino / Evaluation of the modified capsular tension ring in cases of traumatic lens subluxation

OBJETIVO: Avaliar o comportamento do anel modificado de tensão capsular em cataratas traumáticas com subluxação, analisando a acuidade visual, centração do saco capsular, pseudofacodonese, seguimento pós-operatório, e complicações intra e pós-operatórias. LOCAL: Cincinnati Eye Institute, Cincinnati, Ohio, USA. MÉTODOS: Vinte e dois olhos de 22 pacientes com perda traumática de suporte zonular foram submetidos à facoemulsificação utilizando lente intra-ocular de câmara posterior e o implante do anel capsular modificado. O exame pré-operatório incluiu melhor acuidade visual corrigida (MAVC), a presença ou ausência de facodonese, descentração do cristalino e prolapso vítreo. A avaliação pós-operatória incluiu MAVC, presença de pseudofacodonese, centração do implante, necessidade de vitrectomia e outras complicações. RESULTADOS: Vinte e um olhos (95,45 por cento) tiveram melhora da MAVC. O exame pré-operatório revelou facodonese em 11 olhos (50 por cento) e nenhum olho apresentou pseudofacodonese. No exame pré-operatório, a descentração sintomática estava presente em 10 olhos (45,45 por cento). Todos os olhos apresentaram centração do complexo saco capsular/LIO no pós-operatório. Prolapso vítreo foi diagnosticado antes da cirurgia em 9 olhos (40,90 por cento) e a vitrectomia foi necessária em 11 olhos (50 por cento). CONCLUSÃO: O uso do anel modificado de tensão capsular resultou em boa centração do complexo saco capsular/lente intra-ocular nos olhos estudados com catarata traumática e perda de suporte zonular.

PURPOSE: To evaluate the behavior of the modified capsular tension ring (MCTR) in traumatic subluxated cataracts analyzing the visual acuity, centration of the capsular bag, pseudophacodonesis, postoperative follow-up and intra- and postoperative complications. SETTING: Cincinnati Eye Institute, Cincinnati, Ohio, USA. METHODS: Twenty-two eyes of 22 patients with traumatic loss of zonular support had phacoemulsification using PCIOL and MCTR implantation. The preoperative examination included best correct visual acuity (BCVA) and the presence or absence of phacodonesis, lens decentration and vitreous prolapse. The postoperative evaluation included BCVA, the presence of pseudophacodonesis, PCIOL centration, necessity of vitrectomy and other complications. RESULTS: 21 eyes (95.45 percent) had an improvement in BCVA. The preoperative examination disclosed phacodonesis in 11 eyes (50 percent) and no eye presented pseudophacodonesis in the postoperative period. Preoperatively, symptomatic decentration was presented by 10 eyes (45.45 percent) and 22 eyes (100 percent) had no decentration after surgery. The preoperative examination revealed vitreous prolapse in the anterior chamber in 9 eyes (40.90 percent). Vitrectomy was required in 11 eyes (50 percent). CONCLUSIONS: The use of the MCTR resulted in a good centration of the capsular bag and the PC IOL in 22 eyes with traumatic cataract and loss of zonular support.

Pseudophakic retinal detachment with ruptured posterior lens capsule.

The relationship between retinal detachment and posterior lens capsule rupture in pseudophakic patients was studied. Records of patients with pseudophakic retinal detachment who were admitted to Siriraj Hospital from 1992 to 2004 were reviewed. The patients were divided into 2 main groups: 1) The study group (pseudophakic retinal detachment) 79 eyes (78 cases) which was subdivided into group 1a) pseudophakic retinal detachment with intact posterior lens capsule (50 eyes), and group 1b) pseudophakic retinal detachment with ruptured posterior lens capsule (29 eyes); 2) The control group 99 eyes (90 cases) which was subdivided into group 2a) pseudophakic patients with intact posterior lens capsule (83 eyes), and group 2b) pseudophakic patients with ruptured posterior lens capsule (16 eyes). The relationship between pseudophakic retinal detachment and posterior lens capsule rupture was analyzed by Chi-square test, and risk factors were analyzed by multiple logistic regression. Retinal detachment in pseudophakic patients was found more often in males more than in females, and the average age was 57.9 +/- 11.8 years, the retinal detachment was related to posterior lens capsule rupture (p = 0.003). Patients with pseudophakic retinal detachment with a ruptured posterior lens capsule had a risk 5.7 times greater than pseudophakic patients with an intact posterior lens capsule (adjusted Odds ratio = 5.716, 95% CI = 2.118-15.427). The present study showed that posterior lens capsule rupture increased the risk of retinal detachment. Ophthalmologists should be aware of retinal detachment development after YAG capsulotomy, especially in patients who have other risk factors such as myopia, lattice degeneration, retinal break, or previous retinal detachment surgery.