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P.K. Luke, M. Rauser; Anterior Capsule Contraction Syndrome With the AcrySof SA60AT Lens – A Comparison of Surgical Techniques . Invest. Ophthalmol. Vis. Sci. 2005;46(13):779.
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Purpose: To compare the incidence of anterior capsule contraction syndrome (ACCS) before and after modifying surgical techniques on patients receiving the AcrySof SA60AT intraocular lens (IOL). Methods: Two groups of patients receiving the AcrySof SA60AT IOL were compared for the incidence of ACCS before and after modification of techniques during cataract surgery. The first retrospective chart review performed on patients between 7/11/00 and 6/17/02 (group 1) included the standard 5–mm capsulorhexis opening and no anterior capsule polishing. A second retrospective chart review was performed on patients between 1/1/03 and 12/31/03 (group 2) during which time the surgical technique was modified to enlarge the capsulorhexis opening to 5.5 mm with anterior capsule polishing of residual lens epithelial cells. The duration of postoperative follow–up, the patient's age, the presence of known risk factors for ACCS, the presence of ACCS, and the need for Nd:YAG capsulotomy were noted. Cases with posterior capsule tears, infections, anterior vitrectomies, or postoperative follow–up of less than 1 month were excluded. Charts for a total of 230 eyes in group 1 and 378 eyes in group 2 were found to meet the inclusion criteria and were subsequently compared with each other. Results: A 3% incidence of ACCS requiring Nd:YAG anterior capsulotomy was found in group 1 while no cases of ACCS (0%) required such treatment in group 2 (p<0.001). For cases of mild ACCS not requiring Nd:YAG anterior capsulotomy, 3 were found in group 1 while 2 were found in group 2. Conclusions: Implementing a larger capsulorhexis opening of 5.5 mm and polishing the undersurface of the anterior capsule reduces the risk of ACCS requiring Nd:YAG anterior capsulotomy following implantation of the AcrySof SA60AT IOL.
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