Phacoemulsification and Scleral Fixation of the Capsule-Intraocular Lens Complex Using a New Capsular Stabilization Device
To describe the use of the new capsular stabilization hook (modified capsule expander, M-CE) for repositioning and scleral fixation of the lens capsule in patient with subluxated lens.
Summary of Content
Loss of significant zonular support presents a challenge for cataract surgery during implantation of intraocular lens (IOL). An ordinary capsule expander (CE) is a capsular hook that suspends and stabilizes the lens capsule to provide intraoperative stability. The CE is flexible, 10.0 mm in length, and fashioned from 5-0 nylon. The contact portion is bent at 1.25 mm with an end bifurcating to form a T-shape to minimize stress on the capsular equator. A modified capsule expander (M-CE) is 50.0mm in length, and is attached to a curved needle to permanently fix the lens capsule to the sclera.
This is a case of 70-year-old patient with subluxated cataractous lens. After continuous curvilinear capsulorhexis (CCC) was completed, phacoemulsification and aspiration (PEA) was performed with the aid of CEs. Then, scleral fixation of the lens capsule was performed using M-CE. The sclera was penetrated externally by a 25G needle. A needle attached to the M-CE was guided to pass through the ciliary sulcus. The T-shaped tip was easy to insert from a 1-mm small side-port incision. The dislocated capsule was returned to the center with the capsulotomy margin hooked and pulled by the M-CE. The enlargement was created and scleral fixation was performed with 10-0 suture. The lens subluxation was managed by 2 M-CE implants. The IOL was inserted in the capsular bag. The eternized M-CE was trimmed slightly long to avoid slippage with buried under the scleral flap. The capsule-IOL complex had maintained its central position 7 months after operation. The capsule bag was expanded with the capsulotomy margin hooked by M-CEs. There were no complications such as suture erosion or suture knot exposure.
M-CEs were successfully implanted and the capsule-IOL complex continued to maintain its central position. M-CE was effective in fixating the lens capsule to the sclera.
[ Keyword ]
Lens subluxation / Capsular stabilization hook / Capsule expander / Scleral fixation of capsule-IOL complex / Modified capsule expande
[ Conflict of Interest ]
[ Conflict of Interest (Potential conflict) ]
Shigeo Yaguchi is the inventor of the modified capsule expander and received financial support from Handaya Co. Ltd., Tokyo, Japan.