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Modified capsulorhexis for fiuid-filled mature cataracts

BACKGROUND: The aim of this study was to develop a modified capsulorhexis technique featuring a new maneuver for the removal of subcortical fluid in fluid-filled mature cataracts to avoid high intralenticular pressure. METHODS: This prospective interventional study included 33 eyes with mature catar...

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Autor principal: Ghoneim, Ehab M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Virtual Ophthalmic Research Center 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460229/
https://www.ncbi.nlm.nih.gov/pubmed/37641610
http://dx.doi.org/10.51329/mehdioptometry1422
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author Ghoneim, Ehab M.
author_facet Ghoneim, Ehab M.
author_sort Ghoneim, Ehab M.
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description BACKGROUND: The aim of this study was to develop a modified capsulorhexis technique featuring a new maneuver for the removal of subcortical fluid in fluid-filled mature cataracts to avoid high intralenticular pressure. METHODS: This prospective interventional study included 33 eyes with mature cataracts and evidence of subcapsular fluid spaces by slit lamp examination. For each patient, 20% mannitol was administered intravenously according to the bodyweight 1 h preoperatively. Under peribulbar anesthesia, a 2.2-mm main incision was made, and the anterior chamber was filled with a dispersive ophthalmic viscosurgical device. Using a bent-tip cystotome, a 2-mm curved incision was made in the center of the anterior capsule, which released subcortical fluid and was drained through compression of the posterior lip of the main incision using a spatula. Then, fine gentle milking in all quadrants around the puncture on the anterior lens capsule from the periphery toward the site of puncture using the blunt-edged spatula further assists drainage of subcortical fluid and breaks fine septa inside the lens to remove fluid from intralenticular fluid pocket collections. RESULTS: The study included 15 (45.5%) men and 18 (54.5%) women with a mean (standard deviation [SD]) of age of 63.2 (5.33) and 64.4 (6.21) years, respectively. The modified capsulorhexis technique was performed for 33 intumescent cataracts. Capsulorhexis was completed in all cases; capsulorhexis was easy in 31 (94%) eyes and difficult in 2 (6%) eyes. In the two difficult cases, radial extension occurred in one eye, and it was retrieved using the Little technique; the other case with radial tear was completed successfully using a retinal micro scissor from the other edge of the capsulorhexis until reaching an oval, continuous capsulorhexis. CONCLUSIONS: This modified capsulorhexis technique with compression on the posterior lip of the main incision and capsule milking allowed for a safe, continuous curvilinear capsulorhexis. Further comparative studies are necessary to confirm our preliminary results.
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spelling pubmed-104602292023-08-28 Modified capsulorhexis for fiuid-filled mature cataracts Ghoneim, Ehab M. Med Hypothesis Discov Innov Ophthalmol Original Article BACKGROUND: The aim of this study was to develop a modified capsulorhexis technique featuring a new maneuver for the removal of subcortical fluid in fluid-filled mature cataracts to avoid high intralenticular pressure. METHODS: This prospective interventional study included 33 eyes with mature cataracts and evidence of subcapsular fluid spaces by slit lamp examination. For each patient, 20% mannitol was administered intravenously according to the bodyweight 1 h preoperatively. Under peribulbar anesthesia, a 2.2-mm main incision was made, and the anterior chamber was filled with a dispersive ophthalmic viscosurgical device. Using a bent-tip cystotome, a 2-mm curved incision was made in the center of the anterior capsule, which released subcortical fluid and was drained through compression of the posterior lip of the main incision using a spatula. Then, fine gentle milking in all quadrants around the puncture on the anterior lens capsule from the periphery toward the site of puncture using the blunt-edged spatula further assists drainage of subcortical fluid and breaks fine septa inside the lens to remove fluid from intralenticular fluid pocket collections. RESULTS: The study included 15 (45.5%) men and 18 (54.5%) women with a mean (standard deviation [SD]) of age of 63.2 (5.33) and 64.4 (6.21) years, respectively. The modified capsulorhexis technique was performed for 33 intumescent cataracts. Capsulorhexis was completed in all cases; capsulorhexis was easy in 31 (94%) eyes and difficult in 2 (6%) eyes. In the two difficult cases, radial extension occurred in one eye, and it was retrieved using the Little technique; the other case with radial tear was completed successfully using a retinal micro scissor from the other edge of the capsulorhexis until reaching an oval, continuous capsulorhexis. CONCLUSIONS: This modified capsulorhexis technique with compression on the posterior lip of the main incision and capsule milking allowed for a safe, continuous curvilinear capsulorhexis. Further comparative studies are necessary to confirm our preliminary results. International Virtual Ophthalmic Research Center 2021-08-05 /pmc/articles/PMC10460229/ /pubmed/37641610 http://dx.doi.org/10.51329/mehdioptometry1422 Text en © Author(s). https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
spellingShingle Original Article
Ghoneim, Ehab M.
Modified capsulorhexis for fiuid-filled mature cataracts
title Modified capsulorhexis for fiuid-filled mature cataracts
title_full Modified capsulorhexis for fiuid-filled mature cataracts
title_fullStr Modified capsulorhexis for fiuid-filled mature cataracts
title_full_unstemmed Modified capsulorhexis for fiuid-filled mature cataracts
title_short Modified capsulorhexis for fiuid-filled mature cataracts
title_sort modified capsulorhexis for fiuid-filled mature cataracts
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460229/
https://www.ncbi.nlm.nih.gov/pubmed/37641610
http://dx.doi.org/10.51329/mehdioptometry1422
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