Capsular Tension Ring and Iris Hook Use in The Management of Cataract with Phacoemulsification Method in Dogs
Year 2024,
, 68 - 75, 25.06.2024
Osman Bulut
,
Ayşe İpek Akyüz Ünsal
,
Ali Belge
Abstract
The purpose of this study is to evaluate the surgical outcome of capsular tension ring and iris hook use during phacoemulsification in dogs with zonular weakness and miotic pupils. This study includes nineteen dogs (29 eyes) that underwent phacoemulsification (15 dogs/25 eyes) and extracapsular cataract extraction surgery (4 dogs/4 eyes) between February 2014 and February 2015. Patients with any ophthalmic problem other than cataracts were not included in the study. Some dogs did not achieve pharmacologic pupil dilation. These dogs required the use of iris hooks or the insertion of capsular tension rings. The capsular tension ring insertion was used in dogs with zonular rupture in more than half of the zonules. Capsular tension rings were inserted in cases of zonular dialysis and iris hooks were placed to widen the pupil. Fifteen dogs (25 eyes) underwent phacoemulsification, while 4 (4 eyes) received extracapsular cataract extraction (ECCE) surgery due to the difficulty of phacoemulsification in hypermature cataracts. Iris hooks were used in four dogs (8 eyes) for drug-resistant miotic pupils. Capsular tension rings were inserted to stabilize the lens capsule during phacoemulsification and to centralize the intraocular lens (IOL) in the bag. Capsular tension rings in cases of zonular dialysis and iris hooks in drug-resistant miotic pupils improved the success of cataract operations with phacoemulsification. Both are safe and useful for zonular weakness and for maintaining mydriasis during surgery.
References
- Ahmed IK, Cionni RJ, Kranemann C, Crandall AS, 2005: Optimal timing of capsular tension ring implantation: Miyake-Apple video analysis. J Cataract Refract Surg, 31, 1809-1813.
- Alagoz G, Yalcin A, Serin D, Sahap Kukner A, Elcioglu M, Celebi S, 2009: Fakodonezisli Katarakt Olgusunda İris Germe Kancaları ile Lensin Korneaya Asılması. Duzce Uni Tip Fak Derg, 11, 48-50.
- Balal S, Jbari AS, Nitiahpapand R, Cook E, Akhtar W, Din N, Sharma A, 2021: Management and outcomes of the small pupil in cataract surgery: iris hooks, plugin ring or phenylephrine? Eye, 35, 2714-2718.
- Bayraktar S, Altan T, Kucuksumer Y, Yilmaz OF, 2001: Capsular tension ring implantation after capsulorhexis in phacoemulsification of cataracts associated with pseudoexfoliation syndrome. Intraoperative complications and early postoperative findings. J Cataract Refract Surg, 27, 1620-1628.
- Chen TM, Lasarev MR, Eaton JS, 2023: Retrospective investigation of perioperative risk factors for immediate postoperative corneal erosions in dogs undergoing phacoemulsification. Vet Ophthalmol, 26, 191-204.
- Dowler KK, Middleton JR, Dufour S, Hood AM, Giuliano EA, 2021: Characterization of postoperative ‘’fibrin web’’ formation after cataract surgery. Vet Ophthalmol, 24, 37-47.
- Dularent T, Steun L, Isard PF, 2023: Eye trauma from a cat scratch with retention of the claw in the anterior chamber in a dog. Open Vet J, 13, 388-393.
- Edelmann ML, Mohammed HO, Ledbetter EC, 2022: Retrospective evaluation of phacoemulsification and aspiration in 182 eyes: Visual outcomes and CDE-predictive value. Vet Ophthalmol, 25, 316-325.
- Jacob S, Agrawal A, Agrawal S, Patel N, Lal V, 2003: Efficacy of capsular tension ring for phacoemulsification in eyes with zonular dialysis. J Cataract Refract Surg, 29, 315-321.
- Johnstone N, Ward DA, 2005: The incidence of posterior capsule disruption during phacoemulsification and associated postoperative complication rates in dogs: 244 eyes (1995-2002). Vet Ophthalmol, 8, 47-50.
- Kershner RM, 2002: Management of the small pupil for clear corneal cataract surgery. J Cataract Refract Surg, 28, 1826-1831,
- Kugelberg M, Wejde G, Jayaram H, Zetterstrom C, 2006: Posterior capsule opacification after implantation of a hydrophilic or a hydrophobic acrylic intraocular lens: One-year follow-up. J Cataract Refract Surg, 32, 1627-1631.
- Ma X, Li Z, 2014: Capsular tension ring implantation after lens extraction for management of subluxated cataracts. Int J Clin Exp Pathol, 7, 3733-3738.
- Maggs DJ, Nasisse MP, Marrion RM, Priddy NH, Doham JR, 2010: Effects of intracameral administration of α – chymotrypsin on intracapsular lens extraction and postoperative outcome in clinically normal dogs. Am J Vet Res, 71, 1475-1483.
- Menapace R, Sacu S, Georgopoulos M, Findl O, Rainer G, Nishi O, 2008: Efficacy and safety of capsular bending ring implantation to prevent posterior capsule opacification: Three-year results of a randomized clinical trial. J Cataract Refract Surg, 34, 1318-1328.
- Nderitu P, Ursell P, 2019: Iris hooks versus a pupil expansion ring: Operating times, complications, and visual acuity outcomes in small pupil cases. J Cataract Refract Surg, 45, 167-173.
- Newbold GM, Kelch WJ, Chen T, Ward DA, Hendrix DV, 2015: Phacoemulsification outcomes in Boston terriers as compared to non‐Boston terriers: a retrospective study (2002–2015). Vet Ophthalmol, 21, 353-361.
- Nishi O, Nishi K, Mano C, Ichihara M, Honda T, 1998: The inhibition of lens epithelial cell migration by a discontinuous capsular bend created by a band-shaped circular loop or a capsule-bending ring. Ophthalmic Surg Lasers, 29, 119-125.
- Praveen MR, Vasavada AR, Singh R, 2003: Phacoemulsification in subluxated cataract. Indian J Ophthalmol, 51, 147-154.
- Santosh HK, Ranganath L, Nagaraja BN, Satyanarayana ML, Narayanaswamy M, 2019: Studies on the influence of capsular tension ring (CTR) on intraocular lens (IOL) implantation following phacoemulsification in cataractous dogs. J Entomol Zool Stud, 7, 1071-1078.
- Saroğlu M, 2013: Kedi ve Kopek Goz Hastaliklari. 2nd ed., Nobel Tip Kitabevleri, Türkiye.
- Sigle KJ, Nasisse MP, 2006: Long-term complications after phacoemulsification for cataract removal in dogs: 172 cases (1995–2002). J Am Vet Med Assoc, 228, 74-79.
- Vasavada A, Singh R, 2000: Phacoemulsification in eyes with a small pupil. J Cataract Refract Surg, 26, 1210-1218.
- Wilkie DA, Hoy SS, Metzler AG, Colitz CMH, 2015: Safety study of capsular tension ring use in canine phacoemulsification and IOL implantation. Vet Ophthalmol, 18, 409-415.
Köpeklerde Fakoemülsifikasyon Tekniği ile Katarakt Cerrahisinde Kapsül Germe Halkası ve İris Kancası Kullanımı
Year 2024,
, 68 - 75, 25.06.2024
Osman Bulut
,
Ayşe İpek Akyüz Ünsal
,
Ali Belge
Abstract
Bu çalışmanın amacı, miyotik pupilla ve zonuler zayıflığa sahip köpeklerin fakoemülsifikasyon operasyonunda, kapsül germe halkası ve iris kancalarının kullanımının cerrahi sonuçlarını değerlendirmektir. Çalışmanın materyalini, Şubat 2014 ve Şubat 2015 tarihleri arasında, katarakt cerrahisi için fakoemülsifikasyon (15 köpek/25 göz) ve ekstrakapsüler katarakt ekstraksiyonu (EKKE) (4 köpek/4 göz) uygulanan toplam 19 köpek oluşturdu. Katarakt harici başka bir göz hastalığı olanlar çalışmaya dahil edilmedi. Operasyonlar sırasında pupillada miyosis şekillenen bazı köpeklere iris kancaları, zonüler zayıflığı olanlara ise kapsül germe halkası yerleştirildi. Kapsül germe halkaları aynı zamanda lens kapsülü stabil hale getirmek ve intraokuler lensi (İOL) kapsül içinde sentralize etmek için kullanıldı. Miyosis şekillenen toplam 4 köpekte (8 göz) iris kancaları kullanıldı. Fakoemülsifikasyon işlemi ile katarakt ekstrasksiyonu gerçekleşemeyen 4 köpekte EKKE uygulandı. Zonüler zayıflık için kapsül germe halkaları ile pupillar miyosise karşı iris kancaları kullanımının katarakt operasyonlarının başarısını arttırdığı tespit edildi.
Supporting Institution
Aydın Adnan Menderes University as a scientific research
References
- Ahmed IK, Cionni RJ, Kranemann C, Crandall AS, 2005: Optimal timing of capsular tension ring implantation: Miyake-Apple video analysis. J Cataract Refract Surg, 31, 1809-1813.
- Alagoz G, Yalcin A, Serin D, Sahap Kukner A, Elcioglu M, Celebi S, 2009: Fakodonezisli Katarakt Olgusunda İris Germe Kancaları ile Lensin Korneaya Asılması. Duzce Uni Tip Fak Derg, 11, 48-50.
- Balal S, Jbari AS, Nitiahpapand R, Cook E, Akhtar W, Din N, Sharma A, 2021: Management and outcomes of the small pupil in cataract surgery: iris hooks, plugin ring or phenylephrine? Eye, 35, 2714-2718.
- Bayraktar S, Altan T, Kucuksumer Y, Yilmaz OF, 2001: Capsular tension ring implantation after capsulorhexis in phacoemulsification of cataracts associated with pseudoexfoliation syndrome. Intraoperative complications and early postoperative findings. J Cataract Refract Surg, 27, 1620-1628.
- Chen TM, Lasarev MR, Eaton JS, 2023: Retrospective investigation of perioperative risk factors for immediate postoperative corneal erosions in dogs undergoing phacoemulsification. Vet Ophthalmol, 26, 191-204.
- Dowler KK, Middleton JR, Dufour S, Hood AM, Giuliano EA, 2021: Characterization of postoperative ‘’fibrin web’’ formation after cataract surgery. Vet Ophthalmol, 24, 37-47.
- Dularent T, Steun L, Isard PF, 2023: Eye trauma from a cat scratch with retention of the claw in the anterior chamber in a dog. Open Vet J, 13, 388-393.
- Edelmann ML, Mohammed HO, Ledbetter EC, 2022: Retrospective evaluation of phacoemulsification and aspiration in 182 eyes: Visual outcomes and CDE-predictive value. Vet Ophthalmol, 25, 316-325.
- Jacob S, Agrawal A, Agrawal S, Patel N, Lal V, 2003: Efficacy of capsular tension ring for phacoemulsification in eyes with zonular dialysis. J Cataract Refract Surg, 29, 315-321.
- Johnstone N, Ward DA, 2005: The incidence of posterior capsule disruption during phacoemulsification and associated postoperative complication rates in dogs: 244 eyes (1995-2002). Vet Ophthalmol, 8, 47-50.
- Kershner RM, 2002: Management of the small pupil for clear corneal cataract surgery. J Cataract Refract Surg, 28, 1826-1831,
- Kugelberg M, Wejde G, Jayaram H, Zetterstrom C, 2006: Posterior capsule opacification after implantation of a hydrophilic or a hydrophobic acrylic intraocular lens: One-year follow-up. J Cataract Refract Surg, 32, 1627-1631.
- Ma X, Li Z, 2014: Capsular tension ring implantation after lens extraction for management of subluxated cataracts. Int J Clin Exp Pathol, 7, 3733-3738.
- Maggs DJ, Nasisse MP, Marrion RM, Priddy NH, Doham JR, 2010: Effects of intracameral administration of α – chymotrypsin on intracapsular lens extraction and postoperative outcome in clinically normal dogs. Am J Vet Res, 71, 1475-1483.
- Menapace R, Sacu S, Georgopoulos M, Findl O, Rainer G, Nishi O, 2008: Efficacy and safety of capsular bending ring implantation to prevent posterior capsule opacification: Three-year results of a randomized clinical trial. J Cataract Refract Surg, 34, 1318-1328.
- Nderitu P, Ursell P, 2019: Iris hooks versus a pupil expansion ring: Operating times, complications, and visual acuity outcomes in small pupil cases. J Cataract Refract Surg, 45, 167-173.
- Newbold GM, Kelch WJ, Chen T, Ward DA, Hendrix DV, 2015: Phacoemulsification outcomes in Boston terriers as compared to non‐Boston terriers: a retrospective study (2002–2015). Vet Ophthalmol, 21, 353-361.
- Nishi O, Nishi K, Mano C, Ichihara M, Honda T, 1998: The inhibition of lens epithelial cell migration by a discontinuous capsular bend created by a band-shaped circular loop or a capsule-bending ring. Ophthalmic Surg Lasers, 29, 119-125.
- Praveen MR, Vasavada AR, Singh R, 2003: Phacoemulsification in subluxated cataract. Indian J Ophthalmol, 51, 147-154.
- Santosh HK, Ranganath L, Nagaraja BN, Satyanarayana ML, Narayanaswamy M, 2019: Studies on the influence of capsular tension ring (CTR) on intraocular lens (IOL) implantation following phacoemulsification in cataractous dogs. J Entomol Zool Stud, 7, 1071-1078.
- Saroğlu M, 2013: Kedi ve Kopek Goz Hastaliklari. 2nd ed., Nobel Tip Kitabevleri, Türkiye.
- Sigle KJ, Nasisse MP, 2006: Long-term complications after phacoemulsification for cataract removal in dogs: 172 cases (1995–2002). J Am Vet Med Assoc, 228, 74-79.
- Vasavada A, Singh R, 2000: Phacoemulsification in eyes with a small pupil. J Cataract Refract Surg, 26, 1210-1218.
- Wilkie DA, Hoy SS, Metzler AG, Colitz CMH, 2015: Safety study of capsular tension ring use in canine phacoemulsification and IOL implantation. Vet Ophthalmol, 18, 409-415.