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

After extracapsular cataract extraction and posterior chamber intraocular lens implantation on 62 high myopic patients(79 eyes) whose axial lengths were more than 26.0mm, the authors investigated the differences between the calcualted, predicted, peroperative values and measured postoperative values retrospectively. The patients were divided into 2 groups according to their axial lengths; Group C is 35 patients (44 eyes) with 26.0-28.4mm. Group D is 27 patients(35 eyes) with more than 28.4mm. Group A, as control group, is 70 patients(81 eyes) with 22.0-24.4mm and group B, as control group, is 37 patients(44 eyes) with 24.5-25.9mm. Autorefractive examination and manifest refraction was done at 1week, 1month, 3 months postoperatively. Preoperative intraocular lens diopter was calculated by SRK-II and SRK/T formula. After the scleral incision, continuous circumlinear capsulorhexis, and phacoemulsification, one-piece PMMA lens was implanted in the bag. At postoperative 3 months, all patients had the tendency of myopic shift and the shift calculated by SRK-II was much more than that by SRK/T. The difference was statistically significant. In conclusion, it is better to apply SRK/T formula when axial length is more than 26.0mm, in order to acheive goal diopter postoperatively.
Capsulorhexis ; Cataract Extraction ; Cataract* ; Humans ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Phacoemulsification ; Polymethyl Methacrylate ; Retrospective Studies

PURPOSE: The study was done to introduce the new small incision sutureless extracapsular cataract extraction (ECCE) surgical technique and its safety using phaco prechopper. METHODS: After 4.5 mm scleral frown incision from 2 mm surgical limbus, continuous curvilinear capsulorhexis and complete hydrodissection, nucleus was divided into 2 fragments with phaco prechopper which is special forceps for nuclear divider in the bag. One piece of lens was drawn into anterior chamber from capsular bag using Sinskey hook and removed it with Wilder lens loop (size:4 x15 mm) from anterior chamber. The other piece of lens was removed with the same method. To evaluate the safety of new method compared to phacoemulsification (P.E), analysis of the serial changes of the corneal endothelial cell density, hexagonal pattern and mean cell sizes before and 3months after the operation in 40eyes (ECCE group : 20eyes, P.E group : 20eyes) was made. RESULTS: There were no significant complications such as posterior capsular rupture, vitreous loss, capsulorhexis tear but transient corneal edema was found. The mean percentage of corneal endothelial cell loss was 9.05+/-6.5% in ECCE group and 9.80+/-6.7% in the P.E group. CONCLUSIONS: This new method is safe, easy and does not require expensive instrumentation. It can be of great help for the phaco beginners to practice capsulorhexis, hydrodissection and the use of phaco system. We think it is an alternative method for phacoemulsification in cataract surgery.
Anterior Chamber ; Capsulorhexis ; Cataract ; Cataract Extraction ; Cell Size ; Corneal Edema ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Phacoemulsification ; Rupture ; Surgical Instruments

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

Combined penetrating keratoplasty, cataract extraction, and lens implantation is the currently accepted treatment of choice for patients with combined corneal and cataract diseases. However, surgeons have met some difficulties and disadvantages of "Open sky" extracapsular cataract extraction during the triple procedure because of open-system approach. Thus, author contrive "Quadri" procedure ; Combined Phototherapeutic Keratectomy, Penetrating Keratoplasty, Phacoemulsification and Posterior Chamber Lens Implantation, for closed-system approach, and performed successfully.
Cataract ; Cataract Extraction ; Humans ; Keratoplasty, Penetrating* ; Phacoemulsification*

As a study that the incision size was changed at each step of the surgical procedure but it is different, from the universal assumption that. the incision width initially created by a keratome during cataract extraction remained same size after the end of the surgical procedure, the authors investigated a comparative study between the two studies. We used specially designed instrument for accurate measuring of the incision size in 100 eyes and the incision size was measured after the creation of the initial incision, after the coirlpletion of phacoemulsification, after widening the incision and after the folded IOL insertion. Dividing group A and B in 50 eyes respectively, we designated the incision enlargement with 3.0mm keratome as A and 3.2mm keratome as B. It appeared statistically significant widening of the incision by approximately 0.06mm after the completion of phacoemulsification, 0.19mm after the folded IOL insertion in group A and 0. 05mm, 0.1mm in group B, respectively. Future studies of the surgical techniques and the postoperative healing after small incision cataract surgery must measure the actual incision size to avoid misleading assumption that the keratome size at the beginning of the procedure determines the incision size at. the end of the procedure.
Cataract ; Cataract Extraction ; Lenses, Intraocular* ; Phacoemulsification*

In order to compare the corneal sensation after phacoemulsification and the planned extracapsular cataract extraction(p-ECCE), we studied 40 eyes of 31 patients prospetively. A Cochet-Bonnet esthesiometer was used to measure corneal sensitivity preoperatively and at one day, three day, one week, one month, and two months postoperatively, by the same surgeon using the same technique. There was no difference in corneal sensation between phacoemulsification and p-ECCE group preoperatively. The mean corneal sensitivity at 10:00(2:00) o`clock in phacoemulsificantion/p-ECCE was 17.3+/-7.0(18.2+/-6.7)/9.9+/-1.5(10.3+1.9), 22.1+/-6.9 (23.2+/-6.3)/14.1+/-2.3(14.3+/-2.3), 29.4+/-7.7(30.6+/-7.2)/17.7+2.2(18.7+/-2.2), 37.7+/-9.3(37.8+/-9.4)/26.3+/-7.9(27.7+/-8.4), 56.3+/-7.6(56.3+7.9)/59.2+/-3.8(59.4+/-2.7)mm after 1, 3, 7, 30, 60 days, respectively. Corneal sensation at the center and the 3, 6, and 9 o`clock positions was not changed in all eyes. Corenal sensitivity was significantly more recovered in phacoemulsification group than the p-ECCE group at postoperative onemonth(p<0.05). However, there were no statistically significant difference in recovery of corneal sensation between phacoemulsification group and p-ECCE group at postoperative two months. Conclusively corneal sensation returned to peroperative level at two months postoperatively in both groups.
Cataract Extraction* ; Cataract* ; Humans ; Phacoemulsification* ; Sensation*

To evaluate the abnormal positions of intraocular lens after cataract extraction and intraocular lens implantation, the study used the image analysis technique. Tilting and decent ration of posterior chamber intraocular lens(PCL) were studied according to the anterior capsulotomy. 103 patients(120 eyes) were randomized into 6 groups(20 eyes each) according to posterior chamber lens style and anterior capsulotomy type, and measured the degrees of tilting and decent ration of PCL by Scheimpflug camera. Three piece PCL implantation group showed significant less tilting than one piece PCL implantation group at postoperative 1 week. In one radial tear of anterior capsulotomy group, three piece PCL showed less tilting than one piece PCL. At postoperative 2 months, continuous curvilinear capsulorhexis without radial tear group showed significant less decent ration and tilting than one radial tear group. At postoperative 1 week and 2 months tilting of the continuous curvilinear capsulorhexis group was less than two or more radial tears group. As time passes from 1 week to 2 months tilting decreased significantly, but decentration did not showed significant decrease.
Capsulorhexis ; Cataract Extraction ; Lens Implantation, Intraocular ; Lenses, Intraocular

A group of 25 preoperative against-the-rule(AR) eyes had undergone phacoemulsification and posterior chamber lens implantation, 15 of them prepared with lateral(temporal) scleral pocket incision and 10 with superior scleral incision. Temporal incision group showed early AR astigmatism increment by about 1 diopter(D), which decayed slowly over the next 2 months. Superior incision group showed early with-the-rule (WR) astigmatism by about 2.5D, which shifted toward AR astigmatism at postoperative 10 day and the AR astigmatism increased substantially by the next 2 months. The early postoperative complications were hyphema(2 eyes, 13.3%) and corneal edema(1 eye, 6.7%) in the temporal incision group, which cleared spontaneously within 1 week pctoperative. There were no hyphema and corneal edema in the superior incision group. In summary, the temporal incision effectively achived rapid post-operative astigmatic recovery with strong axial stability in a manner that surgically induced astigmatism favorably reduces pre-existing AR astigmatism.
Astigmatism ; Cataract Extraction* ; Cataract* ; Corneal Edema ; Hyphema ; Phacoemulsification ; Postoperative Complications

PURPOSE: The purpose of this study was to compare the postoperative contrast sensitivity and optical aberration between monofocal and multifocal IOL implanted patients. METHODS: Postoperative contrast sensitivity and optical aberration were measured for 7 cataract patients, 12 eyes that underwent monofocal IOL implantation and for 8 cataract patients, 9 eyes that underwent multifocal IOL implantation. Phacoemulsification was conducted on all patients prior to either multifocal or monofocal IOL implantation, and Multivison Contrast Tester (MCT 8000, Vistech, Dayton, U.S.A.) and WaveScan WavefrontT M system (VISX, Santa Clara, U.S.A.) were used to measure contrast sensitivity and optical aberration. RESULTS: Under the nighttime contrast sensitivity mode, the multifocal-group displayed a statistically significant decrease in contrast sensitivity compared to the monofocal-group (P< 0.01), while there was no statistical difference in the optical aberration index of the two groups. (the multi-group; 0.36, the monogroup; 0.31, p=0.64) CONCLUSIONS: After cataract extraction, there was no difference in the optical aberration between the multifocal IOL implantated patients and the monofocal IOL implanted patients. The decrease in postoperative contrast sensitivity was subjectively greater for multifocal IOL implantated patients than the monofocal IOL implanted patients.
Cataract ; Cataract Extraction ; Contrast Sensitivity* ; Humans ; Lenses, Intraocular* ; Phacoemulsification