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Posterior Capsular-Zonular Disruption in Planned Extracapsular Surgery

Posterior Capsular-Zonular Disruption in Planned Extracapsular Surgery Abstract • The incidence of inadvertent posterior capsule-zonular disruption at each stage of planned extracapsular cataract extraction was studied in a consecutive series of 250 cases. Disruption occurred during nucleus expression in 0.8%, during cortical cleanup in 3.2%, during removal of anterior capsular flaps in 0.4%, during polishing of the posterior capsule in 0.4%, and during posterior chamber lens (Sinskey-style) implantation in 0%. No cases of subluxation of the posterior chamber lens were observed (mean follow-up, 22 months). The overall incidence of posterior capsule-zonular disruption was 4.8%. Vitreous loss occurred in one half of these cases (2.4% of eyes). No cases of dislocation of the nucleus into the vitreous occurred. In 50% of the cases of posterior capsule-zonular disruption (2.4% of eyes), prompt recognition and proper management avoided disruption of the vitreous face. In 80% of these cases with posterior capsule-zonular disruption but intact vitreous face, it was possible to remove sufficient cortex and to proceed with uncomplicated posterior chamber lens implantation. References 1. Jaffe NS, Clayman HM, Jaffe MS: Cystoid macular edema after intracapsular and extracapsular cataract extraction with and without an intraocular lens . Ophthalmology 1982;89:25-29.Crossref 2. Clayman HM, Jaffe NS, Light DS, et al: Intraocular lenses, axial length, and retinal detachment . Am J Ophthalmol 1981;92:778-780. 3. Beyer TL, Vogler G, Shannon D, et al: Protective barrier effect of the posterior lens capsule in exogenous bacterial endophthalmitis . Invest Ophthalmol Vis Sci 1984;25:108-122. 4. O'Donnell FE: Surgical Techniques for Nucleus Expression and Extracapsular Cataract Extraction , in Steele ADM, Drews RC (eds): Butterworths International Medical Reviews . Washington, DC, Butterworth Inc, 1984, vol 2. 5. Yang HK, Kline OR: Posterior Chamber Lens Implant Surgery . New York, Raven Press, 1983. 6. Berger BB, Zweis KO, Peyman GA: Vitreous loss managed by anterior vitrectomy . Arch Ophthalmol 1980;98:1245-1247.Crossref 7. Hutton WL, Synder WB, Vaiser A: Management of surgically dislocated intravitreal fragments by pars plana vitrectomy . Ophthalmology 1978;85:176-189.Crossref 8. O'Donnell FE: EyeSat Clinical Manual on Extracapsular Cataract Extraction and Posterior Chamber Intraocular Lens Implantation . Sarasota, Fla, CME-SAT Inc, 1985. 9. Jaffe NS: Results of intraocular lens implant surgery: The Third Binkhorst Medal Lecture . Am J Ophthalmol 1978;85:13-23. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Posterior Capsular-Zonular Disruption in Planned Extracapsular Surgery

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Publisher
American Medical Association
Copyright
Copyright © 1985 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1985.01050050044013
Publisher site
See Article on Publisher Site

Abstract

Abstract • The incidence of inadvertent posterior capsule-zonular disruption at each stage of planned extracapsular cataract extraction was studied in a consecutive series of 250 cases. Disruption occurred during nucleus expression in 0.8%, during cortical cleanup in 3.2%, during removal of anterior capsular flaps in 0.4%, during polishing of the posterior capsule in 0.4%, and during posterior chamber lens (Sinskey-style) implantation in 0%. No cases of subluxation of the posterior chamber lens were observed (mean follow-up, 22 months). The overall incidence of posterior capsule-zonular disruption was 4.8%. Vitreous loss occurred in one half of these cases (2.4% of eyes). No cases of dislocation of the nucleus into the vitreous occurred. In 50% of the cases of posterior capsule-zonular disruption (2.4% of eyes), prompt recognition and proper management avoided disruption of the vitreous face. In 80% of these cases with posterior capsule-zonular disruption but intact vitreous face, it was possible to remove sufficient cortex and to proceed with uncomplicated posterior chamber lens implantation. References 1. Jaffe NS, Clayman HM, Jaffe MS: Cystoid macular edema after intracapsular and extracapsular cataract extraction with and without an intraocular lens . Ophthalmology 1982;89:25-29.Crossref 2. Clayman HM, Jaffe NS, Light DS, et al: Intraocular lenses, axial length, and retinal detachment . Am J Ophthalmol 1981;92:778-780. 3. Beyer TL, Vogler G, Shannon D, et al: Protective barrier effect of the posterior lens capsule in exogenous bacterial endophthalmitis . Invest Ophthalmol Vis Sci 1984;25:108-122. 4. O'Donnell FE: Surgical Techniques for Nucleus Expression and Extracapsular Cataract Extraction , in Steele ADM, Drews RC (eds): Butterworths International Medical Reviews . Washington, DC, Butterworth Inc, 1984, vol 2. 5. Yang HK, Kline OR: Posterior Chamber Lens Implant Surgery . New York, Raven Press, 1983. 6. Berger BB, Zweis KO, Peyman GA: Vitreous loss managed by anterior vitrectomy . Arch Ophthalmol 1980;98:1245-1247.Crossref 7. Hutton WL, Synder WB, Vaiser A: Management of surgically dislocated intravitreal fragments by pars plana vitrectomy . Ophthalmology 1978;85:176-189.Crossref 8. O'Donnell FE: EyeSat Clinical Manual on Extracapsular Cataract Extraction and Posterior Chamber Intraocular Lens Implantation . Sarasota, Fla, CME-SAT Inc, 1985. 9. Jaffe NS: Results of intraocular lens implant surgery: The Third Binkhorst Medal Lecture . Am J Ophthalmol 1978;85:13-23.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: May 1, 1985

References

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