RESUMO
We describe a technique of pars plicata manual posterior capsulorhexis performed after implantation of an intraocular lens (IOL) in pediatric cataract surgery. The technique can be used to create a posterior capsulectomy of a desirable size in a controlled manner to avoid destabilization of the IOL. It can be applied selectively in cases of pediatric cataract surgery.
Assuntos
Capsulorrexe/métodos , Extração de Catarata , Implante de Lente Intraocular/métodos , Criança , Humanos , Esclerostomia , Retalhos Cirúrgicos , VitrectomiaRESUMO
PURPOSE: To evaluate the anatomic location of the haptic and optic of single-piece sulcus-fixated intraocular lenses (IOLs) and their proximity to the iris and ciliary body using ultrasound biomicroscopy (UBM). SETTING: Iladevi Cataract & IOL Research Center, Ahmedabad, India. METHODS: This retrospective study comprised eyes that had primary sulcus implantation of a single-piece IOL. Eyes had an intact anterior capsulorhexis that could provide uniform IOL support and a preoperative anterior chamber depth (ACD) greater than 2.7 mm. The fixation site of the haptics, distance between the optic edge and iris, optic tilt, anterior chamber angle (ACA), central ACD, and ciliary body edema were evaluated by UBM. RESULTS: The time from surgery to UBM examination was 7 to 85 months. Both haptics were in the sulcus in 7 of the 10 eyes, 1 haptic was abutting the iris and the other was in the sulcus in 2 eyes, and both haptics were embedded in ciliary body in 1 eye. The mean distance between the optic edge and iris was 0.16 mm +/- 0.07 (SD), 0.15 +/- 0.03 mm, and 0.38 mm, respectively. The mean ACA was 40.2 +/- 4.5 degrees (range 30.9 to 45.2 degrees), 34.1 +/- 4.5 degrees, and 44.1 degrees, respectively. The mean ACD was 3.47 +/- 0.24 mm, 3.50 +/- 0.23 mm, and 3.57 mm, respectively. No eye had optic tilt or ciliary body edema. CONCLUSIONS: Implantation of both haptics in the sulcus was not achieved in all eyes. The haptics and optics remained in close proximity to the posterior iris surface.