Abstract
In 64 patients, a capsule-bending ring (CBR), an open poly(methyl methacrylate) (PMMA) ring with a truncated edge profile that should create a sharp bend in the equatorial capsule, was implanted in one eye of patients with a hydroxy(ethyl methacrylate) (HEMA) intraocular lens (IOL). The contralateral eye received only the IOL as control. Anterior capsule opacification (ACO) and shrinkage were significantly reduced in the eyes with the ring. Posterior capsule opacification (PCO) score (EPCO) was 0.235 ± 0.215, 0.287 ± 0.200, and 0.398 ± 0.248 with the ring and 0.530 ± 0.190, 0.670 ± 0.225, and 1.111 ± 0.298 without the ring, at 6 months, 1 year, and 2 years, respectively (P < 0.01 at each period). Nd:YAG laser posterior capsulotomy was performed in 4 eyes with ring and 17 eyes without the ring, respectively, after 2 years (P < 0.01). The CBR significantly reduced anterior capsular fibrosis and shrinkage as well as PCO. The ring may be useful for those patients who are at high risk of developing eye complications from capsular opacification requiring Nd:YAG laser capsulotomy, for those who are expected to undergo vitreoretinal surgery and photocoagulation by facilitating better fundus visualization, and for those who have pediatric cataracts.
Proprietary Interest: The authors have no proprietary interest in the method and products described in this paper.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
“Discontinuous” is a mathematical concept describing a curve that is not continuous; that is, a curve that, at some point, is abruptly broken or interrupted and can no longer continue to be continuous. In other words, at that point, tangential curves cannot be continuously drawn. With regard to the posterior capsule, this point of curve interruption or “discontinuity” is where the posterior capsule and its contact with the sharp edge of the optic are abruptly bent, thus creating a capsular bend.
References
Nishi O (1999) Posterior capsule opacification. Part I: experimental investigations. J Cataract Refract Surg 25:106–117
Tetz M, Nimsgern C (1999) Posterior capsule opacification. Part II: clinical findings. J Cataract Refract Surg 25:1662–1674
Nishi O, Nishi K, Sakanishi K (1998) Inhibition of migrating lens epithelial cells at the capsular bend created by the rectangular optic edge of a posterior chamber intraocular lens. Ophthalmic Surg Lasers 29:587–594
Nishi O, Nishi K (1999) Preventing posterior capsule opacification by creating a discontinuous sharp bend in the capsule. J Cataract Refract Surg 25:521–526
Nishi O, Yamamoto N, Nishi K, Nishi Y (2007) Contact inhibition of migrating lens epithelial cells at the capsular bend created by a sharp-edged intraocular lens after cataract surgery. J Cataract Refract Surg 33:1065–1070
Nishi O (1986) Incidence of posterior capsule opacification in eyes with and without posterior chamber intraocular lenses. J Cataract Refract Surg 12:519–522
Nishi O, Nishi K, Akura J (2002) Speed of capsular bend formation at the optic edge of acrylic, silicone, and poly(methyl methacrylate) lenses. J Cataract Refract Surg 28:431–437
Menapace R, Sacu S, Georgopoulos M et al (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
Nishi O, Nishi K, Mano C et al (1998) The inhibition of lens epithelial cell migration by a discontinuous capsular bend created by a band-shaped loop or a capsule bending ring. Ophthalmic Surg Lasers 29:119–225
Nishi O, Nishi K, Menapace R (1998) Capsule-bending ring for the prevention of capsular opacification: a preliminary report. Ophthalmic Surg Lasers 29:749–753
Nishi O, Nishi K, Menapace R, Akura J (2001) Capsular bending ring to prevent posterior capsule opacification: 2 year follow-up. J Cataract Refract Surg 27:1359–1365
Amon M, Menapace R (1991) Cellular invasion on hydrogel and poly(methyl methacrylate) implants: an in vivo study. J Cataract Refract Surg 17:774–779
Hollick EJ, Spalton DJ, Ursell PG (1999) Surface cytologic features on intraocular lenses. Arch Ophthalmol 117:872–878
Hara T, Hara T, Sakanishi K, Yamada Y (1995) Efficacy of equator rings in an experimental rabbit study. Arch Ophthalmol 113:1060–1065
Nagamoto T, Tanaka N, Fujiwara T (2009) Inhibition of posterior capsule opacification by a capsular adhesion-preventing ring. Arch Ophthalmol 127:471–474
Kavoussi SC, Werner L, Fuller SR et al (2011) Prevention of capsular bag opacification with a new hydrophilic acrylic disk-shaped intraocular lens. J Cataract Refract Surg 37:2194–2200
Dick HB, Schwenn O, Pfeiffer N (1999) Implantation of the modified endocapsular bending ring in pediatric cataract surgery using a viscoadaptive viscoelastic agent. J Cataract Refract Surg 25:1432–1436
Nishi O, Nishi K (2000) Wickströmk. Preventing lens epithelial cell migration using intraocular lenses with sharp rectangular edges. J Cataract Refract Surg 26:1543–1549
Nishi O, Nishi K (2003) Effect of the optic size of a single-piece acrylic intraocular lens on posterior capsule opacification. J Cataract Refract Surg 29:348–353
Nishi O, Nishi K, Ohmoto Y (1996) Synthesis of interleukin-1, interleukin 6, and basic fibroblast growth factor by human cataract lens epithelial cells. J Cataract Refract Surg 22:852–858
Nishi O, Nishi K, Fujiwara T et al (1996) Effects of the cytokines on the proliferation of and collagen synthesis by human lens epithelial cells. Br J Ophthalmol 80:63–68
Nishi O, Nishi K, Imanishi M (1992) Synthesis of interleukin-1 and prostaglandin E2 by lens epithelial cells of human cataracts. Br J Ophthalmol 76:338–341
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer Japan
About this chapter
Cite this chapter
Nishi, O., Nishi, K., Menapace, R. (2014). Capsule-Bending Ring for the Prevention of Posterior Capsule Opacification. In: Saika, S., Werner, L., Lovicu, F. (eds) Lens Epithelium and Posterior Capsular Opacification. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54300-8_19
Download citation
DOI: https://doi.org/10.1007/978-4-431-54300-8_19
Published:
Publisher Name: Springer, Tokyo
Print ISBN: 978-4-431-54299-5
Online ISBN: 978-4-431-54300-8
eBook Packages: MedicineMedicine (R0)