Transscleral Fixation of the Dislocated IOL-Capsular Bag Complex in Contraction Capsular Syndrome
https://doi.org/10.18008/1816-5095-2022-1-77-82
Abstract
Contraction capsule syndrome is a serious complication accompanied by structural changes of the capsule bag. Fibrous changes of the lens capsule are found in the postoperative period, even in cases of uncomplicated primary cataract surgery. A certain influence has both general systemic state of the patient and local predisposing factors: the presence of pseudoexfoliative syndrome, the material and design of IOL, the size and shape of the anterior capsulorexis. The far-reaching pathological process leads to pronounced anatomical disorders. Excessive, asymmetrical fibrosis of the anterior capsule in combination with the capsulorexis phimosis leads to IOL decentration and frontal inclination, as well as to the dislocation of the entire IOL capsule complex due to local defects of the zinc ligament. The article presents the method of transscleral-suture fixation of the dislocated IOL-Capsular bag complex developed as a result of contraction capsule syndrome on clinical examples. Its distinctive advantages are described. Reduction of invasiveness is achieved due to the “one puncture” technique — ab externo, needle 30G. The proposed method is technically simple and reliable due to absence of conjunctiva peritomy, low probability of polypropylene 9-0 biodegradation, and possibility of its application with different IOL models allows to speak about its universality.
About the Authors
D. I. Ivanov
Eye Microsurgery Ekaterinburg Center
Russian Federation
Russian Federation
Ivanov Dmitry I., MD, Head of II Surgical Department, Ophthalmosurgeon
A. Bardin str., 4A, Ekaterinburg, 620149
V. N. Nikitin
Eye Microsurgery Ekaterinburg Center
Russian Federation
Russian Federation
Nikitin Vladimir N., Ophthalmosurgeon of II Surgical Department
A. Bardin str., 4A, Ekaterinburg, 620149
References
1. Pashtaev N.P., Suslikov S.V. Long-term results of 1000 cataract surgery with implantation of a combined IOL. Ophthalmosurgery = Oftal’mohirurgiya. 1997;2:20–24 (In Russ.).
2. Krepste L., Kuzmiene L., Miliauskas A., Januleviciene I. Possible predisposing factors for late intraocular lens dislocation after routine cataract surgery. Medicina. 2013;49(5):229–234.
3. Sacu S., Menapace R., Buehl W., Rainer G., Findl O. Effect of intraocular lens optic edge design and material on fibrotic capsule opacification and capsulorhexis contraction. Journal of Cataract & Refractive Surgery. 2004;30(9):1875–1882. DOI: 10.1016/j.jcrs.2004.01.042
4. Apple D.J. Surgical prevention of posterior capsule opacification. Cataract Refract Surg. 2000;(26):180–187. DOI: 10.1016/s0886-3350(99)00353-3
5. Alintaş A.G., Dal D. Capsule contraction syndrome in Behcet’s disease. Int J Ophthalmol. 2010;3(4):358–360. DOI: 10.3980/j.issn.2222-3959.2010.04.20
6. Shkolyarenko N.Yu, Yusef Yu.N. Changes in the capsule bag of the lens after cataract extraction. Annales of Ophthalmology = Vestnik oftal’mologii. 2005;3:40–43 (In Russ.).
7. Hayashi H., Hayashi K., Nakao F., Hayashi F. Anterior capsule contraction and intraocular lens dislocation in eyes with pseudoexfoliation syndrome. The British Journal of Ophthalmology. 1998;82(12):1429–1432. DOI: 10.1136/bjo.82.12.1429
8. Doan K.T., Olson R.J., Mamalis N. Survey of intraocular lens material and design. Current Opinion in Ophthalmology. 2002;13(1):24–29. DOI: 10.1097/00055735-200202000-00006
9. McCulley J.P. Biocompatibility of intraocular lenses. Eye & Contact Lens. 2003;29(3):155–163. DOI: 10.1097/01.ICL.0000072833.79456.2D
10. Werner L. Biocompatibility of intraocular lens materials. Current Opinion in Ophthalmology. 2008;19(1):41–49. DOI: 10.1097/ICU.0b013e3282f20132
11. Moreno-Montanes J., Sanchez-Tocino H., Rodriguez-Conde R. Complete anterior capsule contraction after phacoemulsification with acrylic intraocular lens and endocapsular ring implantation. J Cataract Refract Surg. 2002;28(4):717–719. DOI: 10.1016/S0886-3350(01)01231-7
12. Malyugin B.E, Morozova Т.А. Historical and modern approaches to the problem of restoring accommodation of the fake eye. Eye = Glaz. 2003;6:12–16 (In Russ.).
13. Spang K.M. Complete occlusion of the opening of the anterior capsulorexis: clinical and pathological correlation. J. New in ophthalmology = Novoe v oftal’mologii. 2000;1:36–37 (In Russ.).
14. Lanzl I.M., Kopp C. Ciliary body detachment caused by capsule contraction. J Cataract Refract Surg. 1999;25(10):1412–1414. DOI: 10.1016/S0886-3350(99)00213-8
15. Salzmann J., Khaw P.T., Laidlaw A. Choroidal effusions and hypotony caused by severe anterior lens capsule contraction after cataract surgery. Am J Ophthalmol. 2000;129(2):253–254. DOI: 10.1016/S0002-9394(99)00319-0
16. Malov V.M., Eroshevskaya E.B., Malov I.V., Bancykina Yu.V. Phimosis of the capsulorexis ring. Point of view. East West = Tochka zreniya. Vostok-Zapad. 2016;3:40–41 (In Russ.).
Review
For citations:
Ivanov D.I., Nikitin V.N. Transscleral Fixation of the Dislocated IOL-Capsular Bag Complex in Contraction Capsular Syndrome. Ophthalmology in Russia. 2022;19(1):77-82. (In Russ.) https://doi.org/10.18008/1816-5095-2022-1-77-82
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