Long-term study of posterior capsular opacification prevention with endocapsular equator rings in humans.

OBJECTIVE: To confirm the effect of a square-edged, closed endocapsular equator ring (E-ring) for preventing posterior capsular opacification (PCO) after cataract extraction. METHODS: Fifty-one eyes underwent cataract surgery associated with E-ring implantation between October 2002 and March 2008. Group 1 included 14 patients (14 eyes) who received an E-ring and intraocular lens (IOL) in 1 eye before March 2006. Their fellow eyes received only an IOL as controls. Group 2 included 23 patients (37 eyes) who received an E-ring and IOL in 1 or both eyes after March 2006 and another 37 age-matched control eyes with only IOL implants. After cataract removal, the E-ring (1.0 mm wide and thick and 9.0 or 9.5 mm long) was implanted in the capsule and an IOL was fixed in the ring. In the control eyes, only an IOL was implanted. The follow-up periods were 2 to 7 years. The PCO value was determined using the Hayashi method. RESULTS: Two years postoperatively in group 1, the PCO value in the central area of the eyes with an E-ring was significantly lower than in the controls (4.4 vs 11.4, respectively; P = .005). No eyes with an E-ring required Nd:YAG laser posterior capsulotomy postoperatively compared with 23 of 51 control eyes (45%). The posterior capsule in the eyes with an E-ring remained transparent without touching the IOL optic. The 9.5-mm ring fit all eyes. CONCLUSION: The 9.5-mm E-ring, which fit all eyes, prevented PCO in human eyes 2 to 7 years postoperatively.

Infero-eyebrow blepharoplasty for the upper eyelids of elderly patients.

AIMS: To describe a procedure for removing excess wrinkles from the upper lids of elderly patients. METHODS: Excess wrinkles were resected with a razor blade and scissors or CO(2) laser along the lower eyebrow margin. Ninety-five patients (average age 74 ± 8.1 years) (157 eyes) underwent this procedure and were followed for at least 6 months postoperatively. RESULTS: The average size of the excised skin was 40 ± 9.7 × 12 ± 3.9 mm. Complications included under-resection, which required another resection in six eyes (4%) and a subcutaneous haemorrhage in two eyes (1%). All patients expressed satisfaction with the final cosmetic results. The incision faded almost completely by 6 months postoperatively without camouflage. CONCLUSION: The design and technique were extremely uncomplicated. The main drawbacks were the long incision line under the eyebrow, a slightly slimmer eyebrow and postoperative brow drop. However, all incision lines faded almost completely by 6 months postoperatively, and brow drop was not problematic in bilateral surgeries. This procedure does not replace the current popular procedure for lid crease formation. However, general ophthalmologists can perform the current simple procedure to remove excess wrinkles from the upper lids of elderly patients.

Epithelial photorefractive keratectomy as an enhancement procedure after laser in situ keratomileusis.

The authors describe the refractive effect of epithelial photorefractive keratectomy (E-PRK) on 10 eyes that had undergone LASIK (group 1) and 13 eyes that had not been operated on (group 2). The central 6 mm was ablated. The mean corneal epithelium removed was 15.64 +/- 8.703 microm in group 1 and 25.23 +/- 7.069 microm in group 2. In group 1, the mean postoperative best uncorrected visual acuity (BUCVA) was 1.24 +/- 0.344, which was sustained for a mean of 2.75 +/- 3.456 months and returned to the preoperative value in 6.1 +/- 4.61 months. In group 2, all patients reported severe ocular pain and the BUCVA decreased except for 2 patients whose eyes reached 1.0 at 1 week postoperatively. All eyes reached the preoperative BUCVA by 1 month. This method is contraindicated for previously unoperated corneas but may be useful to enhance post-LASIK eyes when standard enhancement surgery is problematic.

Preventing posterior capsular opacification with an endocapsular equator ring in a young human eye: 2-year follow-up.

OBJECTIVE: To report the results of a specially designed closed ring with a square edge (endocapsular equator ring) in a young patient to prevent posterior capsular opacification. METHODS: One eye of a 22-year-old atopic patient underwent endocapsular equator ring implantation with a 1-piece polymethylmethacrylate intraocular lens immediately after phacoemulsification at Hara Eye Hospital on January 10, 2003. The solid flexible silicone ring has an outer diameter of 9.0 mm, is 1.0 mm wide and 1.0 mm thick, and has a square edge. The loops of the intraocular lens are fixed in the inner groove of the ring. The contralateral control eye underwent phacoemulsification and implantation with a conventional intraocular lens implantation. The Hayashi method was used to determine the posterior capsular opacification score. RESULTS: The ring retained the transparency of the entire posterior capsule. Two years postoperatively, the posterior capsular opacification score in the central area was 3.75 in the ring eye and 15.25 in the control eye, which underwent Nd:YAG laser capsulotomy 2.5 years postoperatively. CONCLUSION: An endocapsular equator ring effectively prevents posterior capsular opacification in a young patient with atopic cataracts.

Ten-year results of anterior chamber fixation of the posterior chamber intraocular lens.

OBJECTIVE: To report the outcomes in eyes in which a Sinskey-type conventional posterior chamber intraocular lens (PC-IOL) was fixed in the anterior chamber and followed up for an average of 10 years. METHODS: Twenty-one eyes were included in the study. The IOLs were conventional hard PC-IOLs, 13.0 mm in overall length with 6.0-mm polymethylmethacrylate optic and polyvinylidene fluoride loops that tilted 10 degrees anteriorly. RESULTS: At implantation the corneal endothelial cell density in 13 of 21 eyes was 382 to 1580 cells/mm(2) owing to the previous implantation of iris-clip or iridocapsular IOLs. The overall postoperative corneal endothelial cell loss was 30.9%. Six of 14 eyes with a preoperative corneal endothelial cell density less than 2000 cells/mm(2) developed bullous keratopathy. Although serious complications did not occur in 7 eyes with a cell density exceeding 2000 cells/mm(2), an average corneal endothelial cell loss of 26.5% still occurred. Except for 2 eyes, all loops were fixed at the scleral spur and a slight pupillary transformation occurred in only 1 eye. CONCLUSION: Although this procedure is easy to perform and pupillary transformation does not occur, it is not recommended for aphakic eyes owing to the high corneal endothelial cell loss after an average 10-year follow-up.