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I.P. Singh, R.M. Ahuja, J. Brody, T. Nagpal, P.B. Dray, D. Greenberg; A Novel Method of Marking the Anterior Lens Capsule for Aide in Capsulorhexis . Invest. Ophthalmol. Vis. Sci. 2003;44(13):190.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the technical feasibility of using a Kendall Devon skin marking pen in aiding visualization of the anterior lens capsule in performing capsulorhexis in cataract extraction using phacoemulsification in patients with visually significant cataracts.Methods: Informed consent was obtained. All patients had visually significant cataracts with visual acuities < 20/200 Snellen in the operative eye. Patients underwent either a scleral tunnel incision or a clear corneal incision for cataract extraction. After the initial incision was made, viscoelastic substance was injected into the anterior chamber. The tip of a Storz olive-tip posterior capsule polisher was marked with a sterile felt tip Kendall Devon skin marking pen. The polisher was introduced into the anterior chamber and the anterior lens capsule was uniformly marked by the coated polisher to delineate the site of future capsulorhexis. Viscoelastic substance was re-injected into the anterior chamber to imprint the dye onto the anterior lens capsule and protect the corneal endothelium. A capsulorhexis was performed using a bent tip cystotome needle. This was followed by phacoemusification and irrigation/aspiration to remove lens material. A foldable Alcon acrylic Acrysoft intra-ocular lens was placed inside the intact capsular bag. The remainder of the procedure was performed using standard protocols. Results:A total of 15 eyes of 15 patients were included in the study. 10 of the 15 eyes had mature cataracts with no posterior pole visualization. B-scan ultrasonography performed on all 10 eyes did not reveal any abnormalities. The remaining 5 cataracts had nuclear sclerotic and posterior subcapsular changes. Ophthalmic examination was performed at the 1 day, 1 week, and 1 month post-operative period. All patients had improvement of visual acuity subsequent to the cataract extraction. No complications were observed. Conclusions:We report a novel technique using a posterior capsule polisher marked with a sterile felt tip marking pen to aide visualization of the anterior lens capsule in cataract surgery. This technique was effective in teaching capsulorhexis performed in an academic setting. This technique was also effective in mature cataracts when there was difficulty in visualizing the anterior lens capsule. Compared to other available dyes such as Indocyanine Green and Tryptan Blue, this technique is technically feasible and more cost effective, less than $5US per pen. Further studies are needed to evaluate the long-term safety of this technique.
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