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Yusef Yu.N.

Krasnov Research Institute of Eye Diseases;
I.M. Sechenov First Moscow State Medical University (Sechenov University)

Vvedenskiy A.S.

Krasnov Research Institute of Eye Disease

Yusef S.N.

Krasnov Research Institute of Eye Disease

Voronin G.V.

Research Institute of Eye Diseases

Alkharki L.

Krasnov Research Institute of Eye Diseases

Shkolyarenko N.Yu.

Research Institute of Eye Diseases

Fokina N.D.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Differentiated method of surgical prophylaxis against anterior capsular contraction syndrome during phacoemulsification

Authors:

Yusef Yu.N., Vvedenskiy A.S., Yusef S.N., Voronin G.V., Alkharki L., Shkolyarenko N.Yu., Fokina N.D.

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Journal: Russian Annals of Ophthalmology. 2020;136(5): 204‑208

DOI: 10.17116/oftalma2020136052204

Views: 764

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To cite this article:

Yusef YuN, Vvedenskiy AS, Yusef SN, Voronin GV, Alkharki L, Shkolyarenko NYu, Fokina ND. Differentiated method of surgical prophylaxis against anterior capsular contraction syndrome during phacoemulsification. Russian Annals of Ophthalmology. 2020;136(5):204‑208. (In Russ.)
https://doi.org/10.17116/oftalma2020136052204

Подписка 2025 (Russian Annals of Ophthalmology)
 
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Prevention of the anterior capsular contraction syndrome (ACCS) in the late postoperative period in patients with lens subluxation is a current problem of phacoemulsification (PE).

PURPOSE

To develop and clinically evaluate a differentiated method of surgical prophylaxis against ACCS during PE in patients with lens subluxation.

MATERIAL AND METHODS

Phacoemulsification surgery with in-the-bag IOL implantation and postoperative follow-up were carried out in 192 patients (192 eyes) with cataract and lens subluxation. In all patients, complete anterior capsulorhexis at the beginning of the surgery was not possible. A differentiated approach was used for capsulorhexis extension at the final stage of the operation after in-the-bag IOL implantation. Three groups of patients were formed according to the three most common clinical situations.

RESULTS

There were no signs of ACCS development in as many as 189 (98.4%) cases. In 3 (1.6%) cases, slight narrowing of the anterior capsulorhexis opening was noted, however, with no effect to the IOL position and functional results of the operation.

CONCLUSION

The differentiated approach to anterior capsulorhexis in patients with lens subluxation allowed to perform phacoemulsification with in-the-bag IOL implantation and to avoid ACCS development in the late postoperative period.

Keywords:

cataract
lens subluxation
phacoemulsification
intraocular lens
anterior capsular contraction syndrome

Authors:

Yusef Yu.N.

Krasnov Research Institute of Eye Diseases;
I.M. Sechenov First Moscow State Medical University (Sechenov University)

Vvedenskiy A.S.

Krasnov Research Institute of Eye Disease

Yusef S.N.

Krasnov Research Institute of Eye Disease

Voronin G.V.

Research Institute of Eye Diseases

Alkharki L.

Krasnov Research Institute of Eye Diseases

Shkolyarenko N.Yu.

Research Institute of Eye Diseases

Fokina N.D.

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Received:

20.06.2019

Accepted:

24.10.2019

List of references:

  1. Yusef SN, Yusef YuN, Ivanov MN. Some features of phacoemulsification in lens subluxation. Vestnik oftal’mologii. 2013;129(3):12-15. (In Russ.).
  2. Avetisov SE, Avetisov KS, Savochkina O.A. Surgical correction of lens changes in Marfan’s syndrome. Klinicheskaya i eksperimental’naya hirurgiya. Zhurnal im. akad. B.V. Petrovskogo. 2015;2(8):41-46. (In Russ.).
  3. Averkina EA, Gamidov AA, Bol’shunov AV, Gamidov GV. Capsule contraction syndrome in pseudophakia. Vestnik oftal’mologii. 2017;133(5):92-97. (In Russ.). https://doi.org/10.17116/oftalma2017133592-97
  4. Avetisov SE, Gamidov AA, Fyodorov AA, Novikov IA, Averkina EA, Komratova LV, Surnina ZV. Complex morphological assessment of anterior capsule of the lens in patients with capsular contraction syndrome (a clinical case study). Vestnik oftal’mologii. 2018;134(3):57-64. (In Russ.). https://doi.org/10.17116/oftalma2018134357
  5. Burgmüller M, Mihaltz K, Schütze C, Angermann B, Vécsei-Marlovits V. Assessment of long-term intraocular lens (IOL) decentration and tilt in eyes with pseudoexfoliation syndrome (PES) following cataract surgery. Graefes Arch Clin Exp Ophthalmol. 2018;256(12):2361-2367. https://doi.org/10.1007/s00417-018-4132-4
  6. Davison J. Capsule contraction syndrome. J Cataract Refract Surg. 1993; 19(5):582-589. PMID: 8229711.
  7. Hansen S, Crandall A, Olson R. Progressive constriction of the anterior capsular openingfollowing intact capsulorhexis. J Cataract Refract Surg. 1993; 19(1):77-82. PMID: 8426328.
  8. Hayashi H, Hayashi K, Nakao F, Hayashi F. Anterior capsule contraction and intraocular lens dislocation in eyes with pseudoexfoliation syndrome. Br J Ophthalmol. 1999;82(12):1429-1432. https://doi.org/10.1136/bjo.82.12.1429
  9. Hartman M, Rauser M, Brucks M, Chalam K. Evaluation of anterior capsular contraction syndrome after cataract surgery with commonly used intraocular lenses. Clin Ophthalmol. 2018;12:1399-1403. https://doi.org/10.2147/OPTH.S172251
  10. Caporossi A, Casprini F, Tosi GM, Balestrazzi A, Stumpo M, Toti P. Histology of anterior capsule fibrosis following phacoemulsification. J Cataract Refract Surg. 1998;24(10):1343-1346. PMID: 9795849.
  11. Avetisov SE, Gamidov AA, Fedorov AA, Rozinova VN. Morphological assessment of lens capsule after different techniques of cataract extraction. Vestnik oftal’mologii. 2016;132(1):47-52. (In Russ.). https://doi.org/10.17116/oftalma2016132147-52
  12. Hayashi K, Yoshida M, Hirata F, Hayashi H. Anterior capsule relaxing incisions with neodymium:YAG laser for patients at high-risk for anterior capsule contraction. J Cataract Refract Surg. 2011;37(1):97-103.  https://doi.org/10.1016/j.jcrs.2010.07.027
  13. Gamidov AA, Averkina EA, Bolshunov AV, Fedorov AA. Combined YAG-laser capsulotomy in pseudophakic patients with anterior capsular contraction syndrome. Vestnik oftal’mologii. 2017;133(6):45-49. (In Russ.). https://doi.org/10.17116/oftalma2017133645-49
  14. Sacu S, Menapace R, Wirtitsch M, Buehl W, Rainer G, Findl O. Effect of anterior capsule polishing on fibrotic capsule opacification: three-year results. J Cataract Refract Surg. 2004;30(11):2322-2327. https://doi.org/10.1016/j.jcrs.2004.02.092
  15. Gabriel de Figueiredo C, Bordin de Figueiredo G, de Figueiredo J. Aspiration of anterior lens epithelium cells to prevent capsule contraction syndrome in pseudoexfoliation syndrome. J Cataract Refract Surg. 2019;45(4):523-524.  https://doi.org/10.1016/j.jcrs.2018.12.014
  16. Narbut NP. Prevention of anterior lens capsula fibrosis after cataract extraction with intraocular lens implantation. Vestnik oftal’mologii. 2013;129(2):56-57. (In Russ.).

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