Clinical results of the open ring PMMA guider assisted capsulorrhexis in cataract surgery

Jee Hye Lee,Yong Eun Lee,Choun-Ki Joo

doi:10.1186/s12886-018-0782-6

Jee Hye Lee, Yong Eun Lee + Show 1 more

Open Access

https://doi.org/10.1186/s12886-018-0782-6

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Abstract

BackgroundTo compare the results of continuous curvilinear capsulorrhexis(CCC) after application of an open ring-shaped guider compared with a free-hand procedure in eyes with cataracts.MethodsThis study comprised patients undergoing cataract surgery in Seoul St.Mary’s Hospital, The Catholic University of Korea. Eyes were grouped depending on the capsulotomy method; CCC was performed by free-hand procedure on 94 eyes (free-hand group), and it was performed under the guidance after introduction of an open ring-shaped guider on consecutive 89 eyes (guided group). Horizontal and vertical diameter, area and circularity of capsulotomy were measured postoperatively at one day, two months and six months. Differences in parameters and the percentage of ideal capsulorrhexis were analyzed between the two groups.ResultsOn the first postoperative day, the vertical diameter in the guided group (5.24 ± 0.16 mm) was significantly longer than that of the free-hand group (5.01 ± 0.65 mm, P = 0.019). The area of capsulotomy was larger in the guided group (21.55 ± 0.87 mm2) than that of the free-hand group (20.34 ± 2.96 mm2, P < 0.001). Circularity in the guided group (0.84 ± 0.03), was significantly greater than that of the free-hand group (0.69 ± 0.17, P = 0.036). Ideal capsulorrhexis was obtained in 60 eyes (67%) in the free-hand group and 81 eyes (86%) in the guided group.ConclusionsAfter introduction of an open ring-shaped guider, CCC became larger and more circular with less anterior capsular contracture. The rate of acquiring ideal capsulorrhexis was higher in the guided group than it was in the free-hand group for six months after surgery.

Highlights

To compare the results of continuous curvilinear capsulorrhexis(CCC) after application of an open ring-shaped guider compared with a free-hand procedure in eyes with cataracts
Continuous curvilinear capsulorrhexis (CCC) is a standard technique in cataract surgery that is preferable to the can-opener capsulotomy [1]
CCC is essential for the safety of phacoemulsification and intraocular lens (IOL) implantation because it permits safe hydrodissection, cortical cleanup, and IOL centration while preventing posterior capsule opacification (PCO) [2, 3]

Summary

Introduction

To compare the results of continuous curvilinear capsulorrhexis(CCC) after application of an open ring-shaped guider compared with a free-hand procedure in eyes with cataracts. If. The ideal capsulorrhexis is a well-centered opening that perfectly overlaps the IOL optic by 360° [6]. The ideal capsulorrhexis is a well-centered opening that perfectly overlaps the IOL optic by 360° [6] This alignment ensures that the IOL contained in the capsular bag is close to the effective lens position (ELP) to avoid an inaccurate IOL power calculation [7]. When the capsular bag is close to the ELP, it prevents optic tilt, decentration, myopic shift, and capsular opacification due to symmetric contractile forces on the capsular bag that cause a shrink-wrap effect. Newer IOLs, including toric-, multifocal- and accommodating IOLs, are more sensitive to accurate positioning and would benefit from more reproducible sizing, shaping, and centration of the anterior capsulotomy

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