Objective classification of zonular weakness based on lens movement at the start of capsulorhexis

Session Details

Session Title: Moderated Poster Session: Cataract - Complications and Management

Session Date/Time: Sunday 06/09/2015 | 14:00-15:00

Paper Time: 14:30

Venue: Poster Village: Pod 1

First Author: : S.Terade-Yaguchi JAPAN

Co Author(s): :    S. Yaguchi   T. Kozawa   H. Bissen-Miyajima        

Abstract Details

Purpose:

The intraoperative findings of entire capsular bag movement during propagation of rhexis, anterior capsule striae during rhexis, and capsulorhexis ovaling after intraocular lens (IOL) implantation are signs of zonular instability. This study aimed to quantify the zonular weakness based on lens movement at the start of capsulorhexis in eyes that received phacoemulsification (PEA) and IOL implantation, and verify the validity of this classification system by examining the correlation between lens movement and the findings of the anterior capsule striae during rhexis and capsulorhexis ovaling.

Setting:

Retrospective study. Subspecialty Clinic of Cataract Surgery in Complicated Cases, Kozawa Eye Hospital and Diabetes Center, Mito, Japan

Methods:

This study examined 164 consecutive eyes in 140 cases that underwent PEA and IOL implantation. The movement of the lens capsule was measured using images from the video recording of the CCC procedure. Zonular weakness was classified based on the shifted distance: (1) normal with shift under 0.2 mm (Group N), (2) weak with shift between 0.2 to 0.4 mm (Group W), and (3) very weak with over 0.4 mm shift (Group VW). We examined the presence of anterior capsule striae and capsulorhexis ovaling in each group.

Results:

We classified 83 eyes (50.6%) as Group N, 52 eyes (31.7%) as Group W, and 29 eyes (17.7%) as Group VW. Among 164 eyes, anterior capsule striae was observed in 61 eyes (37.2%), and capsulorhexis ovaling was observed in 31 eyes (18.9%). The number of cases that presented with anterior capsule striae and capsulorhexis ovaling were 16 eyes (19.3%) and 3 eyes (3.6%), respectively, in Group N, 26 eyes (50%) and 14 eyes (26.9%), respectively, in Group W, and 19 eyes (65.5%) and 14 eyes (48.3%), respectively, in Group VW.

Conclusions:

Objective classification of zonular weakness based on shifted distance of lens capsule showed agreement with findings of anterior capsule striae and capsulorhexis ovaling. This classification system could be useful to predict the degree of zonular weakness, which would assist in the selection of the appropriate surgical device and approach.

Financial Interest:

NONE