Using a white rabbit model, the effect of the haptic portion of the intraocular lens (IOL) and intracapsular ring on the development of posterior capsular opacification (PCO) after extracapsular cataract extraction (ECCE) with phacoemulsification was studied. Implantation of both the intracapsular ring and IOL developed less PCO than implantation of the IOL alone. ECCE followed by implantation of the intracapsular ring alone also developed less PCO than ECCE alone. Through this experimental work in a rabbit model, it could be conceived that the haptic portion of IOL and the intracapsular ring can prevent the development of PCO.
Animal ; Cataract/prevention & control* ; Cataract/pathology ; Cataract Extraction ; Lens Capsule, Crystalline* ; Lenses, Intraocular* ; Male ; Ophthalmoscopy ; Rabbits

When the continuous circular capsulorhexis (CCC) is being performed, the nucleus delivery using nucleus dislocation into the anterior chamber is safer and easier than using conventional "push and pull" method to maintain an intact lens capsule. This method include such procedures that after CCC, the nucleus being freed in the capsular bag by hydrodissection and hydrodelineation, then hooked with a Sinskey hook and drawn out to the anterior chamber by rotation. It may damage the corneal endothelium because of the manipulation in the anterior chamber. To investigate an effect of this method on the corneal endothelium, we performed two months time analysis of changes of the central corneal endothelial cell density (CECD) in two groups--a group with an extracapsular cataract extraction (ECCE) using nucleus dislocation into the anterior chamber and a group with a conventional ECCE. Eighteen eyes of 18 cataract patients who were operated on with ECCE using nucleus dislocation into the anterior chamber method, and ten eyes of 10 cataract patients who were operated on with a conventional ECCE method were included. The CECD was measured by specular microscopy, preoperatively, postoperatively at 1 month and 2 months. The average endothelial cell loss at postoperative 1 month was 7.20 +/- 2.98% in the experimental group and 7.88 +/- 2.93% in the control group, and at postoperative 2 months was 9.05 +/- 2.96% in the experimental group and 9.34 +/- 2.95% in the control group. The change in CECD between two groups was not statistically significant.
Adult ; Aged ; Anterior Chamber/*surgery ; Cataract Extraction/*methods ; Cell Count ; Endothelium, Corneal/*pathology ; Female ; Humans ; Lens Capsule, Crystalline/*surgery ; Lens Nucleus, Crystalline/*surgery ; Male ; Middle Aged

Alport syndrome is a hereditary, progressive disease characterized by progressive nephritis, sensorineural deafness, and ocular abnormalities, including anterior lenticonus. The ultrastructure of the lens capsule abnormalities in Alport syndrome is reported. Four anterior lens capsules from 31-year-old patient and 26-year-old patient with lenticonus who were affected by the Alport syndrome were obtained at capsulectomy. And all four anterior lens capsules were examined by transmission electron microscopy. The histopathologic findings showed that the thickness of the anterior lens capsules was decreased (4~13 micrometer) and that there were many vascular dehiscences localized at the inner part of the lens capsule. There were large numbers of capsular dehiscences containing fibrillar materials and vacuoles. The anterior capsules were clearly fragile in this disease, forming the basis for the progressive lenticonus and anterior polar cataract.
Adult ; Epithelial Cells/ultrastructure ; Humans ; Lens Capsule, Crystalline/*ultrastructure ; Lens Diseases/genetics/*pathology ; Lens Implantation, Intraocular ; Male ; Nephritis, Hereditary/genetics/*pathology ; Phacoemulsification

A 45-year-old man with retinitis pigmentosa (RP), who had undergone uneventful extracapsular cataract extraction (ECCE) in his right eye eight years previously, and phacoemulsification in his left eye six years previously, had spontaneously dislocated intraocular lenses (IOL) within the capsular bag in both eyes one month apart. We removed the dislocated IOLs, and performed anterior vitrectomy and scleral fixation of the new IOLs. Mild contraction of the capsular bags and uneven distribution of the zonular remnants' clumps along the equator of the capsules were found by scanning electron microscopic (SEM) examination. In this study, we propose the correlation between RP and zonular weakness. To our knowledge, this is the first case report of bilateral spontaneous dislocation of IOLs within the capsular bag of an RP patient.
Adult ; Foreign-Body Migration/*etiology ; Humans ; Lens Capsule, Crystalline/*pathology ; Lens Implantation, Intraocular ; *Lenses, Intraocular ; Ligaments/ultrastructure ; Male ; Microscopy, Electron, Scanning ; Phacoemulsification ; Reoperation ; Retinitis Pigmentosa/*complications ; Vitrectomy

PURPOSE: To investigate the long-term characteristics of cataracts among adults aged 30 to 49 years in Korean over a span of 10 years. METHODS: Subjects between the ages of 30 to 49 years who underwent cataract surgery at St. Mary's Hospital from 1995 to 2004 (n = 976) were included. Patients with a history of ocular trauma, uveitis, other ocular or systemic diseases, and congenital cataracts were excluded. Additional information including type of lens opacity, urban/rural region, and pre- and postoperative visual acuities were analyzed. Lens opacity grading was conducted using Lens Opacity Classification System III. The Cochran-Armitage proportion trend test was used to analyze vision changes with the passage of time. RESULTS: Among the patients who had undergone cataract surgeries, 8.8% (976 / 11,111) met the inclusion criteria. The mean age was 41.7 +/- 5.45 years. Gender breakdown of the patient population included 79.0% male and 21.0% female. In terms of home environment, 60.9% were from an urban region and 39.1% from a rural region. Opacity type included anterior polar (AP), posterior subcapsular (PSC), AP and PSC, cortical, and nuclear in 35.7%, 35.1%, 7.0%, 6.0%, and 5.4% of patients, respectively. At a 2-month postoperative follow-up appointment, 92.7% of patients showed a best-corrected visual acuity of more than 20 / 40. CONCLUSIONS: Predominance of AP and PSC opacities as well as male patients was observed in this study population.
Adult ; Age Distribution ; Age Factors ; Cataract/*epidemiology/pathology ; *Cataract Extraction ; Female ; *Forecasting ; Humans ; Incidence ; Lens Capsule, Crystalline/*pathology ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Retrospective Studies

This study was performed to compare the incidence of posterior capsular opacity (PCO) and refractive errors between hydrophilic (ACR6D, Corneal (R) ) and hydrophobic (MA60BM, AcrySof (R) ) acrylic intraocular lenses (IOLs) over a 3-year follow-up after phacoemulsification surgery. The patients with AcrySof (R) implanted in one eye and Corneal (R) in the other eye were categorized as Group 1 (n=28), while those with one or both eyes implanted with IOLs of the same kind were categorized as Group 2 (AcrySof (R), n=90; Corneal (R), n=95). Refractive errors were evaluated at 3 months and 3 years postoperatively. The incidence of visually significant PCO was investigated 3 years postoperatively. Postoperative refractive values at 3 months were not significantly different between the two groups. However, refractive values at 3 years were significantly different between two IOLs in both groups [AcrySof (R) -0.37 +/- 0.43D, Corneal (R) -0.62 +/- 0.58D in Group 1 (p=0.04) ; AcrySof (R) -0.38 +/- 0.52, Corneal (R) -0.68 +/- 0.54 in Group 2 (p< 0.01) ]. The incidence of visually significant PCO was 14% and 32% in Group 1, and 13% and 28% in Group 2, for the AcrySof (R) and Corneal (R) implants, respectively. The incidence of visually significant PCO of hydrophilic acrylic IOLs was higher than that of hydrophobic acrylic IOLs in the 3-year follow-up. The postoperative 3-year refractive value of Corneal (R) showed myopic shift.
*Acrylic Resins ; Aged ; Cataract/*epidemiology/etiology ; Comparative Study ; Female ; Follow-Up Studies ; Humans ; Hydrophobicity ; Incidence ; Lens Capsule, Crystalline/*pathology ; Lens Implantation, Intraocular ; *Lenses, Intraocular ; Male ; Middle Aged ; Phacoemulsification ; *Postoperative Complications ; Refractive Errors/*epidemiology/etiology

This study was performed to evaluate the efficacy and safety of the capsular tension ring on posterior capsular opacity in comparison with cases undergoing intraocular lens (IOL) implantation alone. We analyzed 127 eyes which had undergone cataract surgery, including capsular tension ring insertion, along with 127 eyes which had undergone IOL implantation alone by the same surgeon from September 1998 to March 2003. In the insertion group, 41 eyes (group A) had been followed up for more than one year after silicone IOL implantation, as had 40 eyes (group B) in the control group. We compared the incidence, type, and degree of capsular opacity between A and B groups and also endothelial cell loss after surgery between the two groups. For insertion group A, the frequency of posterior capsular opacity was lower (7.3%), the duration to development was longer, and the energy required for Nd-Yag capsulotomy of PCO was less than for control group B (25%) (p=0.037). The endothelial cell count loss rate was not significantly different between the two groups (p=0.522). The capsular tension ring is associated with a significantly reduced incidence of posterior capsular opacity and is a safe procedure.
Adult ; Aged ; Aged, 80 and over ; Capsulorhexis/*instrumentation ; Cataract/*prevention & control ; Female ; Humans ; Lens Capsule, Crystalline/*pathology ; Lens Implantation, Intraocular ; Male ; Middle Aged ; Phacoemulsification ; Polymethyl Methacrylate ; Postoperative Complications/*prevention & control ; *Prostheses and Implants ; *Prosthesis Implantation ; Safety ; Treatment Outcome