Saratov JOURNAL of Medical and Scientific Research

OCT-study of the anterior lens capsule after cataract surgery accompanied by pseudoexfolia-tion syndrome

Year: 2020, volume 16 Issue: №1 Pages: 215-220
Heading: Ophtalmology Article type: Original article
Authors: Egorova Е.М., Dulidova V.V.
Organization: S. Fedorov Eye Microsurgery Federal State Institution

The Purpose of the study is to evaluate the condition of the anterior capsule (AC) in patients with pseudoexfoliation syndrome (PEX) after implantation of intraocular lenses (IOL) of different designs. Material and Methods. Optical coherence tomography of the anterior segment was conducted in 58 patients (70 eyes) with PEX after phacoemulsification with implantation of various acrylic lOLs: planar (52 cases) and step-vaulted (18 cases). Results. Over the long-term period we revealed differences in the relationship of AC and IOL. in most cases of planar IOL implantation, the AC after polishing adjoined the IOL surface without changing its morphology. The epithelial metaplasia was noted after implantation of planar lOLs without peeling of AC. The free edge of the AC with unchanged epithelium was observed in all cases of implantation of step-vaulted lOLs. Conclusion. Polishing the anterior capsule after implantation of planar lOLs allows avoiding significant manifestations of contraction capsular syndrome. Implantation of step-vaulted lOLs excludes contact of the anterior capsule with the IOL surface; no manifestations of epithelial metaplasia were observed.

1. Arleo RJ, Arar HH, Hoffman RS. Anterior capsular contraction syndrome and PXF. Cataract Refract Surg Today 2007; 7 (2): 26-9.
2. Zaugg B, Werner L, Neuhann T, et al. Clinicopathologic correlation of capsulorhexis phimosis with anterior flexing of single-piece hydrophilicacrylic intraocular lens haptics. J Cataract Refract Surg 2010; 36 (9): 1605-9.
3. Zeboulon P, Gatinel D. Unusual Internal Astigmatism Due to Severe Capsule Contraction Syndrome. J Refract Surg 2018; 34(1): 65-7.
4. Zinkernagel M, Papazoglou A, Patel CK. Bimanual anterior segment revision surgery for anterior capsule contraction syndrome associated with anterior flexion of intraocular lens haptics. Eye (Lond) 2013; 27 (12): 1388-90.
5. Mamalis N, Brubaker J, Davis D, et al. Complications of foldable intraocular lenses requiring explantation or secondary intervention — 2007 survey update. J Cataract Refract Surg 2008; 34 (9): 1584-91.
6. Salzmann J, Khaw PT, Laidlaw A. Choroidal effusions and hypotony caused by severe anterior lens capsule contraction after cataract surgery. Am J Ophthalmol 2000; 129 (2): 253-4.
7. Wang W, Chen M, Wang Y, Yao K. Bilateral capsule contraction syndrome-induced ciliary body detachment. J Cataract Refract Surg 2015; 41 (2): 468-70.
8. Tsinopoulos IT, Tsaousis KT, Kymionis GD, et al. Comparison of anterior capsule contraction between hydrophobic and hydrophilic intraocular lens models. Graefes Arch Clin Exp Ophthalmol 2010; 248 (8): 1155-8.
9. Kato S, Suzuki T, Hayashi Y, et al. Risk factors for contraction of the anterior capsule opening after cataract surgery. J Cataract Refract Surg 2002; 28 (1): 109-12.
10. Kimura W, Yamanishi S, Kimura T, et al. Measuring the anterior capsule opening after cataract surgery to assess capsule shrinkage. J Cataract Refract Surg 1998; 24: 1235-8. H.Raviv T The perfectly sized capsulorhexis. Cataract Refract Surg Today 2009; 9 (6): 37-41.
12.Aufarth GU, BrezinA, CaporossiA, et al. Comparison of Nd: YAG capsulotomy rates following phacoemulsification with implantation of PMMA, silicone, or acrylic intra-ocular lenses in four European countries. Ophthalmic Epidemiol 2004; 11: 319-29.
13. Tsinopoulos I, Symeonidis C, Frangou E, Dimitrakos SA. Capsule Contraction syndrome in eight cases of hydrophobic one-piece intraocular lens implantation. Clin Exp Optom 2008; 91 (5): 469-72.
14. Choi M, Lazo MZ, Kang M, et al. Effect of number and position of intraocular lens haptics on anterior capsule contraction: A randomized, prospective trial. ВМС Ophthalmol 2018; 18(1): 78.
15. Kim SY, Yang JW, Lee YC, Kim SY Effect of haptic material and number of intraocular lens on anterior capsule contraction after cataract surgery. Korean J Ophthalmol 2013; 27 (1): 7—11.
16. Dong J, Jia Y, Zhang Y, et al. Anterior lens capsule and epithelium thickness measurements using spectral-domain optical coherence tomography. ВМС Ophthalmology 2017; 17 (1): 1-6.
17. Fabrikantov OL, Mikhina IV. Prevention of capsulorhexis phimosis after complicated cataract phacoemulsification. Annals of OGU 2011; 14: 237-8.
18. Deacon J, Shepherd DJ, Brady DG, Paul ML. Foldable intraocular lens and method of making. Patent No.: US 8,382,832 B2: (26.02.2013).
19.Avetisov SE, Gamidov AA, Fedorov AA, Rozinova VN. Morphological assessment of lens capsule after different techniques of cataract extraction. Russian Annals of Ophthalmology 2016; 132 (1): 47-52
20.Menapace R, Wirtitsch М, Findl О, et al. Effect of anterior capsule polishing on posterior capsule opacifica-tion and neodymium: YAG capsulotomy rates: three-year randomized trial. J Cataract Refract Surg 2005; 31 (11): 2067-75.

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