Continuous Curvilinear Capsulorhexis (CCC) Remodeling after CCC Widening with a Nd:YAG Laser

Huyn Chan Shim; Eun Ah Kim; Young Wook Cho

doi:10.3341/jkos.2013.54.1.78

Journal List > J Korean Ophthalmol Soc > v.54(1) > 1009680

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Shim, Kim, and Cho: Continuous Curvilinear Capsulorhexis (CCC) Remodeling after CCC Widening with a Nd:YAG Laser

Original Article

J Korean Ophthalmol Soc 2013;54(1):78-84.

Published online: 25 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.1.78

Continuous Curvilinear Capsulorhexis (CCC) Remodeling after CCC Widening with a Nd:YAG Laser

Huyn Chan Shim, MD, Eun Ah Kim, MD, Young Wook Cho, MD

Daegu Fatima Hospital, Daegu, Korea

Address reprint requests to Young Wook Cho, MD Department of Ophthalmology, Daegu Fatima Hospital #99 Ayang-ro, Dong-gu, Daegu 701-724, Korea Tel: 82-53-940-7140, Fax: 82-53-954-7417, E-mail: vitreo-retina@hanmail.nett

Received 16 March 2012 Accepted 10 August 2012

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 analyze the factors that affected continuous curvilinear capsulorhexis (CCC) remodeling to different shapes after CCC widening with Nd:YAG laser.

Methods

The medical records of patients who underwent CCC widening with Nd:YAG laser between January 2002 and December 2010 in our clinic were retrospectively reviewed. Eyes that underwent phacoemulsification surgery alone or combined phacoemulsification surgery and vitrectomy were eligible for the study. A remodeled CCC with a nearly complete circle was classified as type a, starfish-shape as type b, and not remodeled CCC as type c, The factors that affected CCC remodeling were analyzed.

Results

Among 424 eyes of 316 patients, the type of CCC remodeling had a significant correlation with the time period from phacoemulsification surgery to Nd:YAG CCC widening. There was no significant correlation with age, sex, diabetes, type of intraocular lens, type of surgery and indications for surgery.

Conclusions

CCC widening using Nd:YAG laser was effective and had minimal complications. The sooner the procedure was performed, the more circular CCC remodeling occurred. The capsule's elasticity may influence CCC remodeling, but more studies are needed to clarify other factors.

Keywords: Cataract surgery, Combined surgery, Continuous curvilinear capsulorrhexis, Nd:YAG laser, Remodeling

References

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Figure 1.

Method of capsulorrhexis widening. Laser beam is targeted to the 8 radial lines from capsulorrhexis margin to 0.5–1.0 mm central to the optic rim of intraocular lens.

Figure 2.

Type of capsulorrhexis remodeling. (A) type a, (B) type b, (C) type c.

Figure 3.

Anterior segment photographs of a type, b type, c type ((A) Before Nd:YAG capsulorrhexis widening, (B) After Nd:YAG capsulorrhexis widening, (C) Ten days after capsulorrhexis widening).

Figure 4.

The relationship between the type of capsulorrhexis remodeling and the time of capsulorrhexis widening ((A) type a, (B) type b, (C) type c).

Table 1.

Number of eyes by age, sex, performed operation, inserted intraocular lens, and indication of combined surgery

		a type	b type	c type	Total
Mean age (yrs)		65.77 ± 10.73	64.37 ± 8.31	62.84 ± 9.95
Male	Phaco	41	62	19	122
	Phaco+TPPV	11	12	8	31
	Phaco+TPPV+IO gas	11	11	9	31
	Phaco+TPPV+IO oil	2	4	2	8
Female	Phaco	46	67	27	140
	Phaco+TPPV	17	20	16	53
	Phaco+TPPV+IO gas	10	13	10	33
	Phaco+TPPV+IO oil	3	0	3	6
Inserted intraocular lens	Akreos AO	39	60	25	124
	Aquasense	32	39	21	92
	Hoya	33	43	21	97
	Rayner	15	17	10	42
	IQ	9	18	5	32
	Acrysof	9	7	6	22
	Kelios	1	0	1	2
	Biovue	2	2	1	5
	Allegan surgery	0	2	1	3
	Unkown	1	1	3	5
Indication of combined surgery	PDR	29	31	21	81
	RVO	8	7	6	21
	MP	9	5	6	20
	Uveitis	3	5	6	14
	MH	6	8	2	16
	RRD	3	3	4	10

SPSS 18.0, correlation analysis.

Phaco = phacoemulsification and lens aspiration with intraocular lens implantation in the bag; TPPV = trans pars plana vitrectomy; IO gas = intraocular gas tamponade; IO oil = intraocular silicone oil injection; PDR = proliferative diabetic retinopathy; RVO = retinal vein occlusion; MP = muclar pucker; Uveitis = uveitis with its complications; MH = macular hole; RRD = rhegmatogenous retinal detachment.

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