J Korean Ophthalmol Soc.  2016 Oct;57(10):1563-1569. 10.3341/jkos.2016.57.10.1563.

Clinical Result of Planned Posterior Continuous Curvilinear Capsulorrhexis in Adult Patients

• Shin WB
• Lee SH
• Kim JH
• Chu YK

• KMID: 2355411
• DOI: http://doi.org/10.3341/jkos.2016.57.10.1563

Abstract

PURPOSE
Following planned posterior continuous curvilinear capsulorrhexis (PCCC) during cataract surgery in adults, we evaluated the clinical effects of visual acuity and prevention of posterior capsule opacity.
METHODS
The clinical results were studied retrospectively by comparing 43 eyes of 43 patients who underwent cataract surgery with PCCC (the experimental group) and 46 eyes of 31 patients who underwent cataract surgery without PCCC (the control group). Preoperative and postoperative best corrected visual acuities (BCVAs) of patients were measured. BCVA (using log MAR) and the occurrence of posterior capsule opacity were closely monitored in both groups preoperatively, two months postoperatively, and at each group's final visit (14.6 months postoperatively for the experimental group and 15.7 months for the control group). One-piece plate intraocular lens was used in cataract surgery.
RESULTS
Preoperative BCVA was lower in the control group but not significantly. The 2-month mean postoperative BCVA showed improvement in vision in both the control and experimental groups. In both groups, the BCVA was decreased at the final examination compared with the 2-month postoperative BCVA, and significant differences between the two groups were not observed. Under slit lamp examination, anterior hyaloid opacity was observed in 13 of 43 eyes that underwent PCCC. The decrease in BCVA in 13 eyes with anterior hyaloid opacity was significantly different (p < 0.05) compared with the 2-month postoperative BCVA.
CONCLUSIONS
Considering the effort and operation skills required for PCCC, the clinical benefits are negligible. Since cataract surgery with PCCC can cause reduced vision due to anterior hyaloid opacity, side effects should be disclosed before PCCC is performed.

Keyword

Anterior hyaloid opacity; Cataract surgery; One-piece plate intraocular lens; Posterior continuous curnilinear capsulorrhexis

MeSH Terms

Adult*
Capsulorhexis*
Cataract
Humans
Lenses, Intraocular
Retrospective Studies
Slit Lamp
Vision, Low
Visual Acuity

Figure

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  Figure 1. Grade of lens epithelial cell (LEC) ongrowth in patients with posterior continuous curvilinear capsulorhexis. (A-E) The progress of 0–4 grade, showing aggravated LEC.

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  Figure 2. Preoperative and postoperative best corrected visual acuity in patients with posterior continuous curvilinear capsulorhexis (PCCC) and control group. Results are analyzed using Mann-Whitney U-test. ‘Final visit’ means ‘6–18 months’. BCVA = best corrected visual acuity; Preop = preoperative; Postop = postoperative; M = months.

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  Figure 3. Slit lamp photographs of one year postperative follow up after posterior continuous curvilinear capsulorhexis (PCCC) with each different patient. (A) Appearance of clear posterior continuous curvilinear capsulorhexis area. (B, C) lens epithelial cell (LEC) ongrowth can be seen on the PCCC. White arrows indicate PCCC line, and yellow arrows indicate LEC ongrowth.

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  Figure 4. Preoperative and postoperative visual acuity of 13 eyes, showing anterior hyaloid opacity and reclosure after posterior continuous curvilinear capsulorhexis. ‘Final visit’ means ‘6–18 months’. BCVA = best corrected visual acuity; Preop = preoperative; Postop = postoperative; M = months.

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  Figure 5. Slit lamp photographs of anterior hyaloid opacity and reclosure after 12 to 18months of posterior continuous curvilinear capsulorhexis (PCCC) with each different patient. (A) 18 months after PCCC. Grade 2. (B) 12 months after PCCC. Grade 4. (C) 12 months after PCCC. Grade 2 (D) 12 months after PCCC. Grade 4 (E) 13 months after PCCC. Grade 3. (F) Appearance of after neodymium-doped yttrium aluminium garnet laser capsulotomy on total closure of PCCC. 18 months after PCCC.

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  Figure 6. Changes in visual acuity after neodymium-doped yttrium aluminium garnet laser capsulotomy on control group of eyes with posterior capsule opacity (PCO). ‘Final visit’ means ‘6–18 months’. BCVA = best corrected visual acuity; Preop = preoperative; Postop = postoperative; M = months.

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