Reopening the capsular bag by removing the capsular proliferative membrane to enable secondary in-the-bag intraocular lens implantation in pediatric aphakic eyes.

Autor:	Zhou Y; From the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China (Zhou, Y. Zhang, H. Chen, Bai, Wang, Lin, Li, X. Zhang, Wan Chen, Weirong Chen); Department of Ophthalmology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (Zhou); Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China (X. Zhang)., Zhang Y, Chen H, Bai B, Wang Q, Lin Z, Li J, Zhang X, Chen W, Chen W
Jazyk:	angličtina
Zdroj:	Journal of cataract and refractive surgery [J Cataract Refract Surg] 2024 Mar 01; Vol. 50 (3), pp. 250-256.
DOI:	10.1097/j.jcrs.0000000000001352
Abstrakt:	Purpose: To present a surgical technique for reopening the capsular bag in pediatric aphakia. Setting: Zhongshan Ophthalmic Center, Guangzhou, China. Design: Case series study. Methods: Consecutive pediatric patients with bilateral aphakia requiring secondary intraocular lens (IOL) implantation between July 2021 and June 2022 were included. The diameter of the capsular proliferative membranous ring (PMR) and position of IOL implantation were documented. Various parameters of capsular bag opening during primary cataract removal and secondary surgery were also analyzed. Results: 48 eyes were included with a mean follow-up of 8.1 ± 4.4 months. Using the surgical technique developed in this study, the capsular bag was successfully reopened with in-the-bag (ITB) implantation in 43 eyes (89.6%). ITB implantation was accomplished in all eyes with an outer diameter of PMR ≤5.5 mm and in 3 of 8 eyes (37.5%) with an outer diameter of PMR >5.5 mm. A positive correlation was observed between the primary and secondary anterior capsular opening diameters (ACODs) ( r = 0.422, P = .007) and the primary and secondary posterior capsular opening diameters (PCODs) ( r = 0.619, P < .001). The inner diameter of PMR was found to be positively correlated with secondary PCOD ( r = 0.728, P < .001) and the outer diameter with secondary ACOD ( r = 0.669, P < .001). Conclusions: This was a safe and effective surgical technique for pediatric secondary IOL implantation with maximum preservation of the peripheral capsule. Aphakic eyes with an outer diameter of PMR ≤5.5 mm are preferred for secondary ITB implantation. (Copyright © 2023 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)
Databáze:	MEDLINE
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