Capsular tension ring implantation in cataract patients with pseudoexfoliation

Year 2010, Volume: 37 Issue: 1, 35 - 41, 01.03.2010

Banu Torun Acar Suphi Acar

Abstract

Purpose: To investigate the influence of capsular tension ring (CTR) on prevention of intraoperative complications due to zonular weakness and increased capsular fragility during phacoemulsification of cataracts with pseudoexfo­liation. Materials and methods: 148 eyes of 148 patients who had cataract with pseudoexfoliation underwent pha­coemulsification surgery included. 74 eyes of the first group (study group) were implanted with CTR after hy­drodissection, while CTR was not performed in 74 eyes of control group (Group 2). In both groups, intraoperative complications such as zonular dialysis, conversion to ex­tracapsular cataract extraction (ECCE) or intracapsular cataract extraction (ICCE), posterior capsular rupture, vitreus loss, and early postoperative complications were recorded and compared between two groups. Results: In group 1, no complication occurred in 64 eyes (86.5%) and intraocular lens (IOL) implanted in the bag. In 10 eyes (13.5%) posterior capsule rupture occurred, in 4 of them converted to ECCE, IOL implanted in four eyes. In other 6 eyes, phacoemulsification completed un­derlay viscoelastic. In group 2, no complication occured in 42 eyes and IOL implanted in the bag. In 10 patients (13.5%) zonular dialysis occurred, in 4 of them IOL im­planted in the bag and in 6 of them converted to ICCE and IOL implanted in anterior chamber. Posterior capsule rup­ture occurred in 20 eyes (27.0%), all of them converted to ECCE and IOL was implanted. In 2 eyes capsullorrhexis occurred and converted to ECCE, IOL was implanted in sulcus. Conclusion: In patients with pseudoexfoliation, CTR im­plantation in phacoemulsification simplified the surgery, increased the rate of IOL implanted in the bag and pre­vented complications like IOL desantralization after sur­gery.

Keywords

pseudoexfoliation, phacoemulsification, cap­sular tension ring, outcome

Psödoeksfoliasyonlu katarakt hastalarında kapsül germe halkası uygulanması

Abstract

Amaç: Psödoeksfolyasyonlu katarakt olgularında, fako­emülsifikasyon sırasında kapsül germe halkası (KGH) implantasyonunun, zonül zayıflığı ve artmış kapsül fraji­litesine bağlı gelişebilecek komplikasyonları önlemedeki başarısını değerlendirmek. Gereç ve Yöntem: Fakoemülsifikasyon cerrahisi yapılan psödoeksfolyasyonlu 148 hastanın 148 gözü çalışmaya alındı. Grup 1\'deki (çalışma grubu) 74 göze hidrodissek­siyonu takiben KGH uygulandı, kontrol grubundaki (Grup 2) 74 göze ise KGH uygulanmadı. Tüm olgularda ame­liyat sırasında gelişen zonül diyalizi, arka kapsül rüptü­rü, ekstrakapsüler katarakt ekstraksiyonu (EKKE) ya da intrakapsüler katarakt ekstraksiyonu (İKKE)\'ye dönme, vitreus kaybı gibi intraoperatif komplikasyonlarla, erken postoperatif komplikasyonlar kaydedilerek, sonuçların gruplar arası karşılaştırılması yapıldı. Bulgular: Grup 1\'de 74 gözün 64\'ünde (%86.5) kompli­kasyon gelişmedi ve kapsül içi göz içi lens (GİL) kondu, 10 gözde (%13.5) arka kapsül perfore oldu, bunların 4\'ünde EKKE\'ye geçilerek 2\'sine sulkus lensi, 2\'sine ön kamara lensi kondu. Diğer 6 gözde (%8.1) ise; fakoemülsifikasyon tamamlanarak 4 GİL sulkusa, 2 GİL ön kameraya kondu. Grup 2\'de ise 74 gözün 42\'sinde (%56.8) komplikasyon gelişmedi ve hepsine kapsül içi GİL kondu, 10 hastada (%13.5) zonül diyalizi oldu, bunların 4\'ünde hafif diyaliz vardı ve fakoemülsifikasyon tamamlanarak kapsül içi GİL kondu, 6 gözde ileri derecede zonül diyalizi görüldü ve hepsinde İKKE\'ye geçilerek, ön kamara GİL kondu. Yirmi gözde (%27) arka kapsül perforasyonu gelişti, hepsinde EKKE\'ye geçildi, EKKE\'ye geçilen 14 gözde (%18.9) sul­kusa, 6 gözde ön kameraya GİL implantasyonu yapıldı, 2 gözde kapsüloreksis perifere kaçtığı için EKKE\'ye geçildi ve GİL kondu. Sonuç: Psödoeksfolyasyonlu hastalarda katarakt cerra­hisinde KGH kullanımının; zonül hasarını engelleyip fako­emülsifikasyonu kolaylaştırdığı, kapsül içi GİL implantas­yonu oranını arttırdığı, cerrahi sonrası GİL desantralizas­yonu oluşumunu önemli ölçüde engellediği görüldü.

Keywords

Psödoeksfolyasyon, fakoemülsifikas­yon, kapsül germe halkası, sonuç

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