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

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*

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*

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

PURPOSE: To compare the change in corneal sensitivity after temporal and superior clear corneal incisions in cataract surgery. METHODS: We measured and compared the change in corneal sensitivity in senile cataract patients who had received phacoemulsification using temporal clear corneal incision (group 1) and superior clear corneal incision (group 2). The changes were measured at 1 week, 1 month, and 3 months after surgery using Cochet-Bonnet esthesiometer. RESULTS: There were 25 eyes (20 patients) in group 1 and 25 eyes (23 patients) in group 2. The mean age for each group was 67.2 +/- 8.6 years and 63.0 +/- 6.6 years, respectively. At 1 week after surgery, the sensitivity at the corneal center had a tendency to be decreased in both groups (Group 1: P=0.057, Group 2: P=0.043). No significant changes were observed during the subsequent follow-up period. There were significant decreases in the sensitivity at the incision site in both groups. At 3 months after surgery, the corneal sensitivity was nearly recovered to preoperative values. The postoperative change in corneal sensitivity showed similar patterns in both groups, and group 1 showed a larger decrease. CONCLUSIONS: Postoperative change in corneal sensitivity occurs mainly around the incision site and is recovered to preoperative values within 3 months after surgery.
Cataract Extraction ; Cataract* ; Follow-Up Studies ; Humans ; Phacoemulsification

We studied the postoperative visual outcome of 27 congenital cataract patients(45 eyes) whose preoperative vision was 0.1 or better. Twenty-seven eyes(60%) had nuclear cataract and 11 eyes(24.4%) capsular; 39 eyes(86.7%) bilateral and 6 eyes(13.3%) unilateral. Interms of surgical techniques employed, aspiration was performed in 32 eyes(71.1%), phacoemulsification in 13 eyes(28.9%). Intraocular lenses(IOLs) were implanted in 41 eyes(91.1%), of which the power of IOLs was 15 diopers or less in 19 eyes(46.3%). Prooperative best corrected vision ranged from 0.1 to 0.5. Postoperative corrected vision was 0.8 or better in 29 eyes(64.4%), 0.6 to 0.7 in 6 eyes(13.3%) and 0.5 or worse in 10 eyes(22.2%). Among the eyes with 0.8 or better vision, one eye had unilateral cataract and 28 eyes bilateral. Among 16 eyes(35.8%) with 0.7 or worse vision. 5 eyes had unilateral cataract and 11 eyes bilateral. Bilateral cases showed better visual outcome than unilateral. We had been reserving the operation on congenital cataract patients with possible unclear visual outcome due to postoperative complications and am blyopia. However, cataract extraction and IOL implantation improved not only vision but also subjective symptoms, such as glare and knitting brow, in congenital cataract patients with 0.1 or better corrected vision and without any associated ocular or systemic diseases. The results of this study suggest that cataract extraction and IOL implantation may well improve vision and subjective symptoms in selected congenital cataract patients.
Cataract Extraction ; Cataract* ; Glare ; Humans ; Phacoemulsification ; Postoperative Complications