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Junkichi Kabayama, Shigeo Yaguchi; A Study Of Cataract Surgery Using A Capsule Supporting Device "Capsule Expander". Invest. Ophthalmol. Vis. Sci. 2011;52(14):4722.
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We have developed a new capsule supporting device "Capsule Expander (CE)" for suspending capsular bag, and use of it during phacoemulsification and aspiration (PEA) with severely weak zonules has been reported to stabilize the capsular bag and improve the safety of surgery. We investigated the surgical procedures for cataract surgery with CE and its intraoperative complications.
We retrospectively studied a total of 4636 eyes which underwent cataract surgery from March 2003 to December 2009. Surgeries were performed by one surgeon SY. Indications for CE were a preoperative finding of lens subluxation and a finding of severe phacodonesis during continuous curvilinear capsulorrhexis (CCC) or phacoemulsification.
One hundred eyes of 90 patients performed cataract surgery with CE. The procedures were PEA and intraocular lens (IOL) implantation in the bag in 58 eyes (58%), PEA and IOL implantation with sulcus fixation in 41 eyes (41%), PEA that was changed to extracapsular cataract extraction (ECCE) during surgery in 1 eye (1%). Intraoperative complications were dislocation of the lens nucleus into the inferior vitrous in 1 eye (1%) and posterior capsule rupture in 3 eyes (3%). PEA that was changed to ECCE and dislocation of the lens nucleus occurred in cases of a mature cataract with nuclear hardness of grade 5 according to the Emery-Little classification and where some tearing occurred during CCC.
In the vast majority of cases, use of CE for severely weak zonules allowed PEA and IOL implantation with a small incision. In addition, care must be taken since major complications may develop in eyes with a hard nucleus and an irregular anterior capsulotomy margin.
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