Usefulness of Open Ring Guider for Continuous Curvilinear Capsulorrhexis

Su Ah Kim; Yong Eun Lee; Kyu Yeon Hwang; Choun-Ki Joo

doi:10.3341/jkos.2013.54.10.1494

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Kim, Lee, Hwang, and Joo: Usefulness of Open Ring Guider for Continuous Curvilinear Capsulorrhexis

Original Article

J Korean Ophthalmol Soc 2013;54(10):1494-1500.

Published online: 3 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.10.1494

Usefulness of Open Ring Guider for Continuous Curvilinear Capsulorrhexis

Su Ah Kim, MD, Yong Eun Lee, MD, Kyu Yeon Hwang, MD, Choun-Ki Joo, MD, PhD

Department of Ophthalmology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea

Address reprint requests to Choun-Ki Joo, MD, PhD, Department of Ophthalmology, The Catholic University of Korea Seoul St. Mary's Hospital, #222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea, Tel: 82-2-2258-7621, Fax: 82-2-599-7405, E-mail: ckjoo@catholic.ac.kr

Received 22 March 2013 Revised 30 April 2013 Accepted 26 July 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the size, circularity and repeatability between the conventional manual technique and the open-ring guided continuous curvilinear capsulorrhexis (CCC) technique in cataract surgery.

Methods

The present study comprised 120 eyes divided into two equal groups. In the first group (group A), CCC was performed using a 5.3-mm open ring-shaped caliper and in the second group (group B), CCC was performed using the conventional manual technique. Photographs were taken after each surgical step (CCC, phacoemulsification, Intraocular lens insertion and corneal stromal hydration). The diameter, area and circularity of the anterior capsule were compared between the two groups.

Results

The anterior capsule diameter was 5.32 ± 0.26 mm for group A (coefficient of variation 0.049) and 5.14 ± 0.64 mm for group B (coefficient of variation 0.125); the area was 22.9 ± 0.71 mm² for group A (coefficient of variation 0.031) and 21.40 ± 1.37 mm² for group B (coefficient of variation 0.064). Circularity was 0.93 ± 0.24 for group A (coefficient of variation 0.258) and 0.86 ± 0.78 for group B (coefficient of variation 0.907).

Conclusions

The open ring-guided CCC technique resulted in an increase of diameter and capsulorrhexis area. This method showed superior circularity and repeatability compared to conventional manual technique and can be useful in cataract surgery.

Keywords: Cataract, CCC, Open ring guider for CCC, Circularity, Repeatability

References

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Figure 1.

Open Ring Guider for CCC: Inflexible polymethyl methacrylate caliper ring with an internal diameter of 5.3 mm and external diameter of 5.8 mm. It is easy to insert in the eye because of the shape of an open ring (yellow star).

Figure 2.

(A) Group A was performed by using a 5.3-mm ORGC (a. after CCC, b. after phacoemulsification, c. after IOL insertion and corneal stromal hydration). Group B was performed by using conventional manual technique (d. after CCC, e. after phacoemulsification, f. after IOL insertion and corneal stromal hydration). (B) Image J's graphic program to measure the diameter, area and circularity of anterior capsule were compared between two groups. (A) Photos were taken after each surgical step. (B) Measuring the diameter, area and circularity of anterior capsule.

Figure 3.

Comparison between two groups regarding to the calculated CCC parameters after final step, IOL implantation and corneal stromal hydration stage during cataract surgery.

Figure 4.

The coefficient of variation (CV) represents the CCC repeatability that is defined as the ratio of the standard deviation to the mean, it is a helpful statistic in comparing the degree of variation from one data series to the other. It was observed that the lower the CV, the higher the repeatability.

Table 1.

Preoperative characteristics of the study patients

	ORGC (Group A)	Control (Group B)	p-value
Number of patients	69 ± 12	65 ± 16	0.35
Age (years)	31:29	28:32	0.29
Axial length (mm)	23.77 ± 1.25	24.20 ± 1.87	0.34
ACD (mm)	3.08 ± 0.28	3.14 ± 0.24	0.80
Mean K (D)	43.20 ± 1.26	43.31 ± 1.27	0.32
WTW (mm)	11.72 ± 0.33	11.70 ± 0.35	0.45

Values are presented as mean ± SD.

Table 2.

CCC parameters after each surgical step (CCC, phacoemulsification, IOL insertion and corneal stromal hydration). A shows CCC diameter, B shows CCC area, C shows CCC circularity and D shows CCC repeatability

(A) CCC diameter (mm)
	ORGC (Group A)	Control (Group B)	p-value

After CCC	5.44 ± 0.32	5.25 ± 0.59	<0.05
After phacoemulsification	5.41 ± 0.34	5.21 ± 0.62	<0.05
After IOL insertion	5.32 ± 0.26	5.14 ± 0.64	<0.05
(Coefficient of variation)	(0.049)	(0.125)

(B) CCC area (mm²)

	ORGC (Group A)	Control (Group B)	p-value

After CCC	23.42 ± 0.76	22.05 ± 1.25	<0.05
After phacoemulsification	23.1 ± 0.64	21.84 ± 1.88	<0.05
After IOL insertion	22.92 ± 0.71	21.4 ± 1.37	<0.05
(Coefficient of variation)	(0.031)	(0.064)

(C) CCC circularity
	ORGC (Group A)	Control (Group B)	p-value

After CCC	0.89 ± 0.05	0.78 ± 0.18	<0.05
After phacoemulsification	0.86 ± 0.04	0.73 ± 0.15	<0.05
After IOL insertion	0.88 ± 0.06	0.71 ± 0.16	<0.05
(Coefficient of variation)	(0.0258)	(0.907)

(D) CCC repeatability (CV)
	Diameter	Area	Circularity

ORGC (Group A)	0.049	0.031	0.258
Control (Group B)	0.125	0.064	0.907

Values are presented as mean ± SD.

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