Secondary closure of posterior continuous curvilinear capsulorhexis in normal eyes and eyes at risk for postoperative inflammation.

PURPOSE: To observe the posterior continuous curvilinear capsulorhexis (PCCC) after cataract surgery in control eyes and eyes with an increased risk for postoperative inflammation. SETTING: Department of Ophthalmology, University Hospital Antwerp, Belgium. METHODS: After phacoemulsification, a PCCC was performed before intraocular lens (IOL) implantation in 20 eyes of 18 patients with ocular or systemic conditions that predisposed them for increased postoperative inflammation; e.g., diabetes, uveitis, retinitis pigmentosa (inflammation group). These eyes were compared with 20 eyes of 16 patients who had the same surgical procedure but did not present a history of medical or ocular pathology (control group). The postoperative follow-up was 6 months to 3 years. Reclosure of the PCCC was evaluated by anterior segment photographs. The reclosure was classified as partial when newly formed tissue was present at the PCCC margin and total when the proliferation covered the entire PCCC area. RESULTS: Three types of PCCC reclosure were found: fibrotic, Elschnig pearl or multilayer, and monolayer. All 3 were seen within or at the margin of the PCCC area. Reclosure (total and partial) occurred in 8 eyes (40%) in the control group and 10 (50%) in the inflammation group. Total reclosure was more frequent in the inflammation group (4 eyes [20%]) than in the control group (1 eye [5%]). Monolayered or multilayered cellular proliferation was present in 8 eyes (40%) in the control group and 4 eyes (20%) in the inflammation group; fibrotic proliferation was found in the inflammation group only (7 eyes [35%]). CONCLUSION: Reclosure of the PCCC occurred in both groups, although the frequency of reclosure was slightly higher in the inflammation group. Although PCCC does not prevent posterior capsule opacification in all cases, it is useful in specific situations.

Secondary closure of posterior continuous curvilinear capsulorhexis.

PURPOSE: To examine the hypothesis that removing the center of the posterior capsule would prevent posterior capsular opacification (PCO). SETTING: Department of Ophthalmology, University Hospital Antwerp, Belgium. METHODS: A posterior continuous curvilinear capsulorhexis (CCC) was done before intraocular lens (IOL) implantation in eyes at risk for PCO (uveitic, young adult), retinal detachment after neodymium:YAG (Nd:YAG) laser capsulotomy (highly myopic) or for cystoid macular edema (uveitic, diabetic) and in eyes in which the posterior capsule was opaque intraoperatively. The 51 eyes of 40 patients had a follow-up ranging from 6 months to 2 years. RESULTS: Four eyes (8%) developed partial closure of the posterior CCC without vision impairment; 6 eyes (12%) had total closure, of which 2 (4%) had a loss of two or more Snellen lines necessitating an Nd:YAG laser capsulotomy. CONCLUSION: Young adult eyes and eyes with underlying diabetic retinopathy or uveitis are at risk for total closure of the posterior CCC. Only young adult eyes required Nd:YAG laser capsulotomy after the posterior CCC.

Multifocal intraocular lens implantation in patients with presenile unilateral primary and secondary cataract.

Multifocal intraocular lens implantation was studied in 6 eyes with a unilateral cataract due to ocular trauma. Two patients had an uncomplicated traumatic cataract, two patients had a complicated traumatic cataract and two patients had a unilateral primary presenile cataract. Postoperative visual acuity for distance and for near vision, with and without additional spectacle correction, as well as the presence of postoperative binocular vision was evaluated. Additionally, we looked for pre- and postoperative parameters, assuming these criteria determine the success ratio of a multifocal intraocular lens implantation: presence of a stereoscopic vision pre-operatively, or absence of a pre-operative strabismus; rather good visual prognosis (no retinal damage in the traumatic cases and no amblyopia in the primary cases); normal functioning of the pupillary sphincter.

Secondary closure of posterior continuous circular capsulorhexis.

We examined the hypothesis that removing the center of the posterior capsule would reduce the risk for posterior opacification (PCO). We considered the prevalence of post-operative complications after PCCC like retinal detachment and cystoid macular edema, as found after Nd-YAG laser capsulotomy.