A new method is presented for removal of secondary membranes using a cryomicroprobe. In all 11 cases reported, membranes were removed intact as one piece. There were no complications at surgery or afterwards.
Capsule Opacification* ; Cryosurgery* ; Membranes

Posterior capsule opacification(PCO) is a common complication of cataract surgery. The presence of a posterior chamber intraocular lens has been shown to decrease the incidence of the development of PCO. Moreover, there are evidences that the design of intraocular lens may also alter its development. Extracapsular lens extraction with implantation of posterior chamber lens were operated on a consecutive series of 230 eyes. These were evaluated in the viewpoint of PCO development after surgery. All were sulcus fixed and their optic designs were devided into two groups; a group of convex-plano lens with continuous laser ridge including convex-concave lens and a group of biconvex lens. The incidence of PCO was lower in convex-plano lens with continuous laser ridge group(6.7%) than that of boconvex lens group(18.9%). The incidence of Nd:YAG posterior capsulotomy marked 0.0% in continuous ridged group and 1.8% in biconvex group(p<0.05, p Capsule Opacification* ; Cataract ; Incidence ; Lenses, Intraocular* ; Posterior Capsulotomy

PURPOSE: To compare contrast sensitivity (CS) in type and degree of posterior capsule opacification (PCO) in pseudophakic eyes before and after neodymium: YAG capsulotomy. METHODS: Nine eyes with fibrosis-type PCO and 26 with Elschnig-pearl type PCO were examined for best corrected visual acuity (BCVA) and CS before and 1 week after capsulotomy. CS was tested with visual capacity analyzer (ACV) which uses a Landolt ring of 5 different spatial frequencies (SF) under two different conditions of day (100cd/m2) and night (30cd/m2). The patients were divided into two groups based on the BCVA before capsulotomy: Group A, 4 eyes and 18 eyes with below 0.63 in fibrosis-type and pearls-type PCO, respectively; Group B, 5 eyes and 8 eyes with above 0.63 in fibrosis-type and pearls-type PCO, respectively. RESULTS: The patients with PCO had worse BCVA and CS, but these were improved by Nd: YAG capsulotomy. This was not affected by the types and degrees of PCO. In the daytime condition, CS of B group was worse at all SF in patients with pearl-type PCO than in those with fibrosis-type PCO before capsulotomy, except 19 cpd (p<0.05). In the nighttime condition, CS in the two groups showed no difference at all SF (p>0.05). CONCLUSIONS: In the daytime condition, the patients with pearls-type PCO of relatively poor BCVA had lower CS than those with fibrosis-type PCO.
Capsule Opacification ; Contrast Sensitivity* ; Humans ; Neodymium ; Visual Acuity

BACKGROUNDPosterior capsule opacification (PCO) compromises vision development in infants after cataract surgery and lead to amblyopia. To observe the effects of curcumin on PCO in infant rabbits, curcumin was injected under the capaule and into the anterior chamber during phacoemulsification.

METHODSSeventy-five 1-month-old healthy New Zealand white rabbits were randomized into 3 groups, one eye of each rabbit was randomly selected to be operated. The operation involved continuous circular capsulorhexis, followed by hydrodissection with 0.6 ml each of balanced salt solution (BSS, group A), hydroxypropyl-β-dodextrin (HP-β-CD, 90 µg/ml, group B) or CUR-HP-β-CD (123 µg/ml, group C), respectively. After phacoemulsification, 0.4 ml of each drug solution was injected into the anterior chamber via an incision. The extent of corneal edema and the inflammatory response within the anterior chamber were considered as measures PCO and observed postoperatively. All eyes were examined 1 and 2 months postoperative by slit lamp microscopy and photography after pupil dilation. On the third day postoperative, 6 rabbits from each group were executed. Paraffin-embedded sections were stained with hematoxylin-eosin (HE) or terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay (TUNEL, indicative of apoptosis). Stained sections were observed under light microscopy. Proliferation of lens epithelial cells (LECs) was observed microscopically on day 3, day 7, month 1 and month 2 after the operation with HE staining.

RESULTSThe remission of cornea edema occurred earlier in group C than in groups A and B (P < 0.05); there were no significant differences between groups A and B. The remission of anterior chamber exudation in group C was earlier than those in groups A and B (P < 0.05). No significant difference in the times when PCO occurred, was observed among groups. Compared to groups A and B, the extent of PCO was less severe (P < 0.05). Three days after the operation, LECs aggregated at the orbit. Meanwhile, minor apoptosis was observed in all groups. One month after the operation transparent, cortex and proliferating LECs were observed near the orbit in groups A and B. Two months postoperative, heavy cortex proliferation was observed in all groups: epithelial cells migrated and aggregated at the posterior capsule and rearranged under the anterior capsule in the control group. Proliferation was also observed in group C, but to a less severe extent than in the other two groups.

CONCLUSIONCUR-HP-β-CD exerts an inhibitory effect on PCO.

Animals ; Capsule Opacification ; drug therapy ; surgery ; Curcumin ; therapeutic use ; Female ; Male ; Phacoemulsification ; methods ; Posterior Capsule of the Lens ; surgery ; Rabbits

The most common cause of blurred vision after extracapsular cataract extraction is known to be an opacification of the posterior lens capsule. The pathogenesis of posterior lens capsule opacification is primarily caused by residual lens epithelial cells. For the prevention of posterior capsular opacification, several kinds of anti-mitotic drugs is being actively investigated. But the antimitotic drugs are not clinically used due to toxicity towards the intraocular tissues. The objectives of this study is to evaluate the effect of mitomycin C and tirilazad mesylate(FREEDOX(TM)) respectively for inhibiting the proliferation of rabbit lens epithelial cells when it is administered in a short period. Lens epithelial cells from white rabbits were harvested andcultured for 4 passages. Mitomycin C was applied for 3 minutes with 0.025mg/ml and 0.05mg/ml in concentration respectively. The proliferation assay was performed by [(3)H]-thymidine uptake test. Significant decrease of lens epithelial cell proliferation appeared in both drugs.When Mitomycin-C was applied with 0.025mg/ml for 3 minutes, cell proliferation was reduced to 31.5% compared with control and in 0.05mg/ml concentration, to 12.5%. When tirilazad mesylate was applied 0.15mg/ml for 3 minutes, cell proliferation was reduced to 46.5% compared with control and in 1.5mg/ml concentration, to 7.5%. If futher investigation would show the effectives and safety of these drugs, these agents could be applied into the lens capsular bad at the time of surgery to prevent the posterior capsular opacification after cataract surgery.
Antimetabolites* ; Antimitotic Agents ; Capsule Opacification ; Cataract ; Cataract Extraction ; Cell Proliferation ; Epithelial Cells* ; Mesylates ; Mitomycin ; Rabbits

PURPOSE: To evaluate the clinical results of thermoplastic, hydrophilic acrylic IOL CV232 (MemoryLens(R), CIVA Vision, USA) to those of hydrophobic acrylic IOL AR40e (Sensar(R), AMO, USA). METHODS: Twenty patients had in-the-bag implantation of a MemoryLens(R) IOL in 1 eye and a Sensar(R) in the opposite eye in a randomized fashion after uneventful phacoemulsification. We evaluated the best corrected visual acuity (BCVA) and posterior capsule opacification (PCO) at a mean 30.05 months after surgery. RESULTS: Two years postoperatively, a BCVA of 0.8 or better was found in 65% of the MemoryLens(R) group and in 60% of the Sensar(R) group. There was no statistically significant differences between the two groups (p>0.50). PCO developed in 55% in the MemoryLens(R) group and in 65% of the Sensar(R) group. Again, no statistically significant differences were found between the two groups (p>0.50). CONCLUSIONS: There were no significant differences between the two different intraocular lenses in BCVA or PCO postoperatively.
Capsule Opacification ; Cataract* ; Humans ; Lenses, Intraocular* ; Phacoemulsification ; Refractive Errors ; Visual Acuity

This study was performed to evaluate the correlationship between posterior capsular opacification and optic configuration of intraocular lens in extracapsular lens extraction with In-the-bag implantation of posterior chamber lens. We retrospectively studied the 455 cases of cataract operations that were performed between January 1993 and January 1995. All were in-the-bag placement and their optic designs were divided into two groups: a group of biconvex lens and a group of convex-plano lens with continuous laser ridge. The incidence of PCO in bicovex lens group was 7.0% and that of convex plano lens with laser ridge group was 7.1%. The difference in the rate of posterior capsular opacification between two groups was not statistically significant. The incidence of Nd: YAG laser posterior capsulotomy revealed 0.0% in continuous ridged group and 2.6% in biconvex group(p>0.05).
Capsule Opacification* ; Cataract ; Incidence ; Lasers, Solid-State ; Lenses, Intraocular* ; Posterior Capsulotomy ; Retrospective Studies

PURPOSE: To compare neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy rates between hydrophobic and hydrophilic intraocular lenses. METHODS: The present retrospective study enrolled patients who received cataract surgery from a single surgeon between July 2006 to December 2009. Patients included in the study were implanted with SA60AT hydrophobic spherical intraocular lenses (Alcon, Fort Worth, TX, USA, 268 eyes) or I-FLEX hydrophilic spheric intraocular lenses (i-Medical®, Ophthalmic International Heidelberg GmbH, Mannheim, Germany, 331 eyes). The Nd:YAG capsulotomy rates and best-corrected visual acuity (BCVA) were compared between the two groups for 2 years after the operation. RESULTS: The mean follow-up period was 23.5 months and 22.6 months and the mean age was 68.6 years and 70.3 years in the SA60AT and I-FLEX groups, respectively. Follow-up periods were longer in the SA60AT group (p = 0.035), but ages were not significantly different between the two groups (p = 0.367). Nd:YAG laser capsulotomy rates were 6.3% in the SA60AT group and 11.2% in the I-FLEX group. Nd:YAG laser capsulotomy rates were significantly higher in the I-FLEX group (p = 0.020). BCVA before and after the Nd:YAG laser capsulotomy was not significantly different. CONCLUSIONS: Nd:YAG laser capsulotomy rates were higher in the I-FLEX hydrophilic spheric intraocular lens group than in the SA60AT hydrophilic spheric intraocular lens group. Adhesion between capsular bag and intraocular lens by bioadhesive character of hydrophobic acryl intraocular lens may contribute to the prevention of lens epithelial migration and posterior capsule opacification.
Aluminum ; Capsule Opacification ; Cataract ; Follow-Up Studies ; Germany ; Humans ; Lenses, Intraocular* ; Retrospective Studies ; Visual Acuity ; Yttrium

PURPOSE: To compare neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy rates between hydrophobic and hydrophilic intraocular lenses. METHODS: The present retrospective study enrolled patients who received cataract surgery from a single surgeon between July 2006 to December 2009. Patients included in the study were implanted with SA60AT hydrophobic spherical intraocular lenses (Alcon, Fort Worth, TX, USA, 268 eyes) or I-FLEX hydrophilic spheric intraocular lenses (i-Medical®, Ophthalmic International Heidelberg GmbH, Mannheim, Germany, 331 eyes). The Nd:YAG capsulotomy rates and best-corrected visual acuity (BCVA) were compared between the two groups for 2 years after the operation. RESULTS: The mean follow-up period was 23.5 months and 22.6 months and the mean age was 68.6 years and 70.3 years in the SA60AT and I-FLEX groups, respectively. Follow-up periods were longer in the SA60AT group (p = 0.035), but ages were not significantly different between the two groups (p = 0.367). Nd:YAG laser capsulotomy rates were 6.3% in the SA60AT group and 11.2% in the I-FLEX group. Nd:YAG laser capsulotomy rates were significantly higher in the I-FLEX group (p = 0.020). BCVA before and after the Nd:YAG laser capsulotomy was not significantly different. CONCLUSIONS: Nd:YAG laser capsulotomy rates were higher in the I-FLEX hydrophilic spheric intraocular lens group than in the SA60AT hydrophilic spheric intraocular lens group. Adhesion between capsular bag and intraocular lens by bioadhesive character of hydrophobic acryl intraocular lens may contribute to the prevention of lens epithelial migration and posterior capsule opacification.
Aluminum ; Capsule Opacification ; Cataract ; Follow-Up Studies ; Germany ; Humans ; Lenses, Intraocular* ; Retrospective Studies ; Visual Acuity ; Yttrium

PURPOSE: We compared the ocular aberration and clinical outcome between different aspheric intraocular lenses (IOL) in both eyes. METHODS: This prospective randomized controlled study was comprised of patients with bilateral cataract who received two different aspheric IOLs implanted in both eyes: negatively aspheric Tecnis® ZCB00 and spherically neutral Akreos® MI60. Total and corneal aberrations computed by Wavescan® and Pentacam® were assessed at 6 months to investigate the effects of the IOL's spherical aberration on the eye and to analyze the incidence and degree of posterior capsule opacification. By using spherical aberration of the cornea and the IOLs, values calculated via Ray-tracing software and Wavescan® were compared. Total spherical aberration was analyzed by the MATLAB program and converting the pupil size to 6.0, 4.5, 3.0 mm. RESULTS: A total of 25 patients were included. Regarding pre-operative corneal aberration, ZCB00 group was 0.232 ± 0.119 µm while MI60 group was 0.240 ± 0.117 µm, and there was no difference between the two IOLs. At 6 months after total ocular spherical aberration, MI60 group (pupil size 6.0 mm; 0.296 ± 0.097 µm, 4.5 mm; 0.094 ± 0.032 µm, 3.0 mm; 0.019 ± 0.006 µm) had more positive values than ZCB00 group (pupil size 6.0 mm; 0.051 ± 0.105 µm, 4.5 mm; 0.009 ± 0.034 µm, 3.0 mm; 0.002 ± 0.007 µm) (p < 0.001). When calculated using the ray tracing method, based on the results after surgery, MI60 group's total spherical aberrations were higher than ZCB00 group. However, from 1 month to 6 months after surgery, the uncorrected distance visual acuity, spherical equivalent and posterior capsule opacification showed no differences between the two IOLs. CONCLUSIONS: In eyes with aspheric IOLs with negative spherical aberration, spherical aberration was lower than spherically neutral aspheric IOLs. Regarding postoperative visual acuity, spherical equivalent and posterior capsule opacification, there were no significant differences between the two groups.
Capsule Opacification ; Cataract ; Cornea ; Humans ; Incidence ; Lenses, Intraocular* ; Methods ; Prospective Studies ; Pupil ; Visual Acuity