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Shin, Lee, Kim, and Chu: Clinical Result of Planned Posterior Continuous Curvilinear Capsulorrhexis in Adult Patients
Original Article

J Korean Ophthalmol Soc 2016;57(10):1563-1569.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.10.1563

Clinical Result of Planned Posterior Continuous Curvilinear Capsulorrhexis in Adult Patients

Woo Beom Shin, MD1, 2, Seung Hyun Lee, MD1, 2, Ji Hyun Kim, MD1, Young Kwang Chu, MD, PhD1

1Siloam Eye Hospital, Seoul, Korea

2The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

Address reprint requests to Young Kwang Chu, MD, PhD Siloam Eye Hospital, #181 Deungchon-ro, Gangseo-gu, Seoul 07668, Korea Tel: 82-2-2650-0880, Fax: 82-2-2650-0725 E-mail: docchu@hotmail.com

Received 4 May 2016       Accepted 20 September 2016

Copyright © 2016 Korean Ophthalmological Society

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

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 post-operative 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.

Keywords: Anterior hyaloid opacity, Cataract surgery, One-piece plate intraocular lens, Posterior continuous curnilinear capsu-lorrhexis

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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.
jkos-57-1563f1.tif
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.
jkos-57-1563f2.tif
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.
jkos-57-1563f3.tif
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.
jkos-57-1563f4.tif
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.
jkos-57-1563f5.tif
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.
jkos-57-1563f6.tif
Table 1.
Study variables and spherical equivalent of PCCC and control group
Variables PCCC
PCCC Control
No. of eye patients 43 46
Age (years) 68.4 ± 7.4 69.1 ± 8.5
Gender (male:female) 20:23 12:34
Follow up (Months) 14.6 ± 5.9 15.7 ± 7.2
Axial length 23.65 23.72
Spherical equivalent    
   Preoperative 0.58 –0.38
   Postoperative (2 month) –0.30 –0.23
   Final visit –0.19 –0.27

Values are presented as mean ± SD unless otherwise indicated.

PCCC = posterior continuous curvilinear capsulorhexis; SD = standard deviation.

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