April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Use of mini-capsulorhexis in the Phaco-Ersatz technique for cataract surgery in a rabbit model
Author Affiliations & Notes
  • Esdras A Arrieta
    Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
  • Mariela C Aguilar
    Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
  • Alejandro Arboleda
    Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
    Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL
  • Mukesh Taneja
    Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
    LV Prasad Eye Institute, Hyderabad, India
  • Pravin Vaddavalli
    LV Prasad Eye Institute, Hyderabad, India
  • Jukka Moilanen
    Helsinki University Central Hospital, Helsinki, Finland
    Vision Cooperative Research Centre, Brien Holden Vision Institute, UNSW, Sydney, NSW, Australia
  • Fabrice Manns
    Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
    Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL
  • Victor Hernandez
    Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
    Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL
  • Jason Watling
    Vision Cooperative Research Centre, Brien Holden Vision Institute, UNSW, Sydney, NSW, Australia
  • Jean-Marie A Parel
    Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL
    Vision Cooperative Research Centre, Brien Holden Vision Institute, UNSW, Sydney, NSW, Australia
  • Footnotes
    Commercial Relationships Esdras Arrieta, None; Mariela Aguilar, None; Alejandro Arboleda, None; Mukesh Taneja, None; Pravin Vaddavalli, None; Jukka Moilanen, None; Fabrice Manns, BHVI-UM Patent Application (P); Victor Hernandez, None; Jason Watling, None; Jean-Marie Parel, BHVI-UM Patent Application (P)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 2804. doi:
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      Esdras A Arrieta, Mariela C Aguilar, Alejandro Arboleda, Mukesh Taneja, Pravin Vaddavalli, Jukka Moilanen, Fabrice Manns, Victor Hernandez, Jason Watling, Jean-Marie A Parel; Use of mini-capsulorhexis in the Phaco-Ersatz technique for cataract surgery in a rabbit model. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2804.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract 
 
Purpose
 

To assess safety and feasibility of phacoemulsification and refilling the capsular bag with a clear polymer through a mini-capsulorhexis (MCR), followed by crosslinking the polymer in a rabbit model.

 
Methods
 

104 eyes of 86 NZW rabbits under general anesthesia were operated by four surgeons (3 in training) over an 18 month period using 4 types of polymers; a double paracentesis was performed, the anterior chamber refilled with viscoelastic, a manual MCR was performed, phacoemulsification with a 0.7mm tip, the rhexis was closed with a miniature capsulorhexis valve (MCV) (Fig 1) and subsequent injection of the polymer was performed using a curved blunt 0.55mm cannula. The clear cornea incision was closed with a single 10-0 nylon and the polymer was crosslinked. Clinical biomicroscopy, tonometry, gonioscopy and funduscopy were performed post-op in all animals at different time points and clinical data was collected.

 
Results
 

Manual MCR ranged 1.19±0.38mm. The most common complications during surgery was MCR tearing in 26 eyes (25 %), anterior capsule tearing in 8 eyes (7.69%), posterior capsule tearing in 9 eyes (8.65%) and leaking polymer during injection was observed in 22 eyes (21.15%). Postoperative clinical features observed were fibrosis around the MCR, posterior synechiae and posterior capsule opacification. In the more recent procedures refraction changes were assessed with an intraoperative autorefractometer adapted to the surgical microscope (OPMI, Fig 2).

 
Conclusions
 

Phacoemulsification through a mini-capsulorhexis is feasible and a safe technique (Fig 1). Learning curve is short. The most common complication was rhexis tearing that might be avoidable using a femto-second laser. All polymers tested were easy to inject, safe and biocompatible. Further studies are underway to assess the accuracy of intraoperative autorefractometer controlled lens refilling.

 
 
Minicapsulorrhexis Valve (MCV)
 
Minicapsulorrhexis Valve (MCV)
 
 
Intraoperative autorefractometer mounted onto the surgical microscope
 
Intraoperative autorefractometer mounted onto the surgical microscope
 
Keywords: 404 accommodation • 445 cataract • 676 refraction  
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