Capsular bag distension with an acrylic intraocular lens.

PURPOSE: To describe the postoperative capsular bag distension that occurs with in-the-bag implantation of the soft acrylic (AcrySof) intraocular lens (IOL). SETTING: Jules Stein Eye Institute, University of California, Los Angeles. METHODS: Nine eyes in nine patients had uncomplicated continuous curvilinear capsulorhexis, phacoemulsification, and in-the-bag implantation of the AcrySof lens. Comprehensive ophthalmic examinations were performed 1 day and 1 and 6 weeks postoperatively. Patients had neodymium:YAG laser posterior capsulotomy; refractions were done before and after the capsulotomy. RESULTS: Comprehensive ophthalmic examination revealed variable degrees of anterior chamber shallowing, anterior displacement of the IOL within the bag, and distension of the posterior capsule away from the IOL. Unexpected postoperative myopic correction was seen in all patients. Postcapsulotomy mean spherical equivalent refractive shift was +3.6 diopters (D) with a shift of at least +4.0 D in four of nine eyes. CONCLUSIONS: Capsular bag distension is a previously described postoperative complication that we observed in association with the AcrySof IOL.

Glaucoma filtration surgery: new horizontal mattress closure of conjunctival incision.

We developed a conjunctival wound closure technique with the idea of decreasing the incidence of wound leak following glaucoma filtration surgery. A micropoint 9-0 nylon vascular needle is used as a running mattress suture to close the limbal conjunctiva in routine fornix-based flap trabeculectomy surgery, trabeculectomy surgery with 5-fluorouracil (5-FU), and combined cataract and trabeculectomy surgery. In a series of 52 eyes in 52 patients in which we used this technique, there have been no cases of flat anterior chamber or significant choroidal effusion, complications often occurring secondary to trabeculectomy which require further intervention.