This study was performed to evaluate histopathologic and physical characteristics of anterior capsule during capsulorhexis with a new high-frequency diathermy.The authors investigated the histopathologic characteristics of anterior capsule according to coagulation time and anterior capsular diameter in diathermy capsulorhesxis(DC),comparing with those in continuous curvilinear capsulorhexis(CCC). Thermally induced histopathologic alter-ation was localized at anterior capsule with coagulation for 0.5 second, while it was extended into cortex with coagulation for 2 seconds.When capsulorhexis was performed with diameter of 6 mmand the margin was pulled with iris retractor,anterior capsular edge was fully extended both in CCC and DC.But with diameter of 3.5 mm,DC mostly led to tear of capsular edge on its extension,while CCC permitted full extension of anterior capsular edge.These results suggest that strength of anterior capsular edge in DC is inferior to that in CCC.However diathermy capsulorhexis is a useful alternative technique in cases,which CCC is difficult to perform,such ashypermature or congenital cataracts.
Capsulorhexis* ; Cataract ; Diathermy* ; Iris

PURPOSE: To compare parameters of femtosecond laser and manual continuous curvilinear capsulorhexis (CCC) using anterior segment optical coherence tomography (AS-OCT). METHODS: Femtosecond laser cataract surgery was performed in 30 eyes of 30 patients, and conventional cataract surgery with a manual CCC in 30 eyes of 30 patients. One month after surgery, CCC diameters, circularity of capsulotomy, and distance between the CCC and pupil center were analyzed using the AS-OCT. RESULTS: Mean maximal CCC diameter was 4.96 +/- 0.23 mm in the femtosecond laser group, and 4.70 +/- 0.82 mm in the manual CCC group. Mean minimal CCC diameter was 4.91 +/- 0.23 mm in the femtosecond group, and 4.48 +/- 0.64 mm in the manual CCC group showing significant difference between the two groups (p = 0.000). Circularity of capsulotomy was 0.99 +/- 0.01 in the femtosecond group and 0.91 +/- 0.13 in the manual CCC group and was statistically different between the 2 groups (p = 0.000). The distance from the CCC center to the pupil center was 0.18 +/- 0.09 mm in the femtosecond group and 0.26 +/- 0.17 mm in the manual CCC group. The CCC center was closer to the pupil center in the femtosecond than in the manual CCC group (p = 0.038). CONCLUSIONS: Properly sized and shaped capsulotomy can be expected in femtosecond laser CCC compared with manual CCC.
Capsulorhexis* ; Cataract* ; Humans ; Pupil ; Tomography, Optical Coherence

PURPOSE: To compare parameters of femtosecond laser and manual continuous curvilinear capsulorhexis (CCC) using anterior segment optical coherence tomography (AS-OCT). METHODS: Femtosecond laser cataract surgery was performed in 30 eyes of 30 patients, and conventional cataract surgery with a manual CCC in 30 eyes of 30 patients. One month after surgery, CCC diameters, circularity of capsulotomy, and distance between the CCC and pupil center were analyzed using the AS-OCT. RESULTS: Mean maximal CCC diameter was 4.96 +/- 0.23 mm in the femtosecond laser group, and 4.70 +/- 0.82 mm in the manual CCC group. Mean minimal CCC diameter was 4.91 +/- 0.23 mm in the femtosecond group, and 4.48 +/- 0.64 mm in the manual CCC group showing significant difference between the two groups (p = 0.000). Circularity of capsulotomy was 0.99 +/- 0.01 in the femtosecond group and 0.91 +/- 0.13 in the manual CCC group and was statistically different between the 2 groups (p = 0.000). The distance from the CCC center to the pupil center was 0.18 +/- 0.09 mm in the femtosecond group and 0.26 +/- 0.17 mm in the manual CCC group. The CCC center was closer to the pupil center in the femtosecond than in the manual CCC group (p = 0.038). CONCLUSIONS: Properly sized and shaped capsulotomy can be expected in femtosecond laser CCC compared with manual CCC.
Capsulorhexis* ; Cataract* ; Humans ; Pupil ; Tomography, Optical Coherence

PURPOSE: To compare the size, circularity and repeatability between the conventional manual technique and the open-ring guided continuous curvilinear capsulorrhexis (CCC) technique in cataract surgery. METHODS: The present study comprised 120 eyes divided into two equal groups. In the first group (group A), CCC was performed using a 5.3-mm open ring-shaped caliper and in the second group (group B), CCC was performed using the conventional manual technique. Photographs were taken after each surgical step (CCC, phacoemulsification, Intraocular lens insertion and corneal stromal hydration). The diameter, area and circularity of the anterior capsule were compared between the two groups. RESULTS: The anterior capsule diameter was 5.32 +/- 0.26 mm for group A (coefficient of variation 0.049) and 5.14 +/- 0.64 mm for group B (coefficient of variation 0.125); the area was 22.9 +/- 0.71 mm2 for group A (coefficient of variation 0.031) and 21.40 +/- 1.37 mm2 for group B (coefficient of variation 0.064). Circularity was 0.93 +/- 0.24 for group A (coefficient of variation 0.258) and 0.86 +/- 0.78 for group B (coefficient of variation 0.907). CONCLUSIONS: The open ring-guided CCC technique resulted in an increase of diameter and capsulorrhexis area. This method showed superior circularity and repeatability compared to conventional manual technique and can be useful in cataract surgery.
Capsulorhexis* ; Cataract ; Chlormequat ; Eye ; Lenses, Intraocular ; Phacoemulsification

As a growing number of surgeons are perforining cataract extraction by phacoernulsification and the continuous curvilinear capsulorhexis [CCC] has rapidly increased in popularity as the anterior capsulotomy technique, its advantages have been reported recently. But its complications induced by capsular contraction after ccc have been noted, and so we have studied the change in anterior capsular opening area and refractive error after ccc. One surgeon performed cataract extraction using ccc and phacoernulsification, and implanted posterior chamber IOL [optic size 5. 5mm, Pharmacia 812A] in the bag in 48 eyes, and we measured the area of anterior capsular opening and refractive error [spherical equivalent] at I week and 3 months after operation. The average percentage of anterior capsular shrinkage rate at 3 months was 14.8% and showed statistically significant difference [P<0.05], but. had not correlation with initial ccc size. The average refractive change at 3 months was 0. 2D hyperopic shift but did not show statistically significant difference.
Capsulorhexis* ; Cataract Extraction ; Perforin ; Phacoemulsification ; Refractive Errors

No Abstract Available.
Adult* ; Capsulorhexis* ; Cataract* ; Follow-Up Studies* ; Humans

We rotated the nucleus up to 270 degree and dislocated it into anterior chamber through the diameter of capsulorhexis after hydrodissection by using the planned extracapsular cataract extraction. And later on we delivered the nucleus with hydroexpression using the irrigating Vectis or with rotation using a lens spatuala. As a result of this procedure, the nucleus was safely delivered in all cases without zonular rupture and vitreous prolapse.
Anterior Chamber ; Capsulorhexis* ; Cataract Extraction* ; Cataract* ; Prolapse ; Rupture

PURPOSE: The authors used a mixture of ICG dye and viscoelastic material to perform continuous curvilinear capsulorhexis (CCC) in white cataract, in order to stain the anterior capsule with the minimal contact with the corneal endothelial cells. METHODS: In 10 eyes with white cataract, CCC was performed under the anterior capsular staining with ICG dye. The ICG solution was prepared by dissolving 25 mg of ICG in 1 mlof an aqueous solvent, which was mixed in 3 ml of balanced salt solution. With a three-way connector, one way was occluded, the other was connected with 1 ml of viscoelastic material, and the third was connected with 4 ml of the prepared ICG solution. One half percent mixture of ICG and viscoelastic material was made by alternate injection. The anterior chamber was filled with viscoelastic material, and then the anterior capsule was stained by slow spread of the prepared ICG mixture between anterior capsule and viscoelastic material. The remains of ICG mixture was removed by infusion and aspiration. The anterior chamber was filled with viscoelastic material again, CCC was performed with cystotome. Corneal edema and anterior chamber reaction was evaluated with slit lamp at 1 day, 1 week and 1 month after surgery. RESULTS: In all cases, CCC was successfully completed under the anterior capsular staining of the desired area with 0.5% ICG dye mixture and there was no contact with the corneal endothelial cells. Mild corneal edema and mild anterior chamber reaction that observed on the 1st postoperative day subsided within 1 week in all cases. CONCLUSIONS: Staining the anterior capsule with 0.5% ICG dye mixture, after the anterior chamber was filled with viscoelastic material, it was helpful to perform CCC in white cataract. Using this technique, we could minimize the contact with the corneal endothelial cells and stain the desired area.
Anterior Chamber ; Capsulorhexis ; Cataract ; Corneal Edema ; Endothelial Cells ; Indocyanine Green*

PURPOSE: We examined the extent of anterior capsular constriction after continuous curvilinear capsulorhexis according to the initial area of opening, the postoperative period, and the material of optics of intraocular lens(IOL). PATIENTS AND METHODS: We measured the area of anterior capsular opening 1 day, 1, 2, 3, 6, and 12 months postoperatively. Sixty five eyes of 50 patients with poly "methyl methacrylate "(PMMA), foldable silicone, and foldable acrylic IOLs were included. RESULTS: There was no significant correlation between the initial area and the extent of anterior capsular constriction(r=0.090, p=0.476). There was significant reduction during the postoperative 3 months but, thereafter, the changes of the area was insignificant. The mean reduction size was larger in order of foldable silicone, PMMA, and foldable acrylic IOL. The difference between foldable silicone and acrylic IOLs was statistically significant(p=0.009). Those between foldable silicone and PMMA IOLs(p=0.580) or between PMMA and foldable acrylic IOLs(p=0.135) was not significant. CONCLUSIONS: The appropriate choice of IOL should be considered as the strategy to reduce the contraction of anterior capsular opening after continuous curvilinear capsulorhexis.
Capsulorhexis ; Constriction ; Humans ; Lenses, Intraocular* ; Polymethyl Methacrylate ; Postoperative Period ; Silicones

Phacoemulsification in hypermature cataract has not been recommended for routine procedure because of the difficult techniques and the possibility of high complication rates.48 eyes of 48 patients with hypermature cataracts were operated with phacoemulsification by one surgeon.The complications related to the status of continuous circular capsulorrhexis (CCC) were prospectively studied for three years.25 eyes (52.1%)had complete CCC and 23 eyes (47.9%)had incomplete CCC, and in 6 (12.5%)of these 23 eyes, posterior capsular rupture was occurred.Decentration of intraocular lens more than 1mm, occurred in 4 eyes (8.3%)with 3 or more radial tears. These results shows that phacoemulsification in hypermature cataract can be considered relatively safe procedure with recent techniques.CCC is also regarded as one of the most important procedures in hypermature cataract as in normal cataracts in reducing complications during and after the operation.
Capsulorhexis ; Cataract* ; Humans ; Lenses, Intraocular ; Phacoemulsification* ; Prospective Studies ; Rupture