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Review
. 2019 Jan;14(1):12-18.
doi: 10.5114/wiitm.2019.81313. Epub 2019 Jan 16.

The evolution of the anterior capsulotomy

Dorota Wyględowska-Promieńska  1   2 , Marcin Jaworski  2 , Kamila Kozieł  2 , Richard Packard  3
Affiliations
Review

The evolution of the anterior capsulotomy

Dorota Wyględowska-Promieńska et al. Wideochir Inne Tech Maloinwazyjne. 2019 Jan.

Abstract

The paper describes the development of the anterior capsulotomy from its early crude beginnings in the 18th century to the possibility of automated surgery today via continuous curvilinear capsulorhexis (CCC). The reasons for the opening of the capsule have changed from a roughly made tear to allow access to the nucleus for its extraction, to the creation of more regular openings to allow support for intraocular lenses. With the development of continuous circular tears it was possible to be certain to contain the intraocular lens (IOL) in the capsular bag. In recent times we have the ability to achieve precision in size and location with lasers and other technologies. This means the capsulotomy can be used to hold the IOL, which will improve the centration of the optic. This is important in premium lenses and should improve predictability of the effective lens position. All of these changes will be highlighted with appropriate illustrations.

Keywords: anterior capsulotomy; cataract; continuous curvilinear capsulorhexis; phacoemulsification.

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Conflict of interest statement

Richard Packard is a consultant to Excel-Lens (USA), which produces CAPSULaser. The other authors declare that there is no conflict of interest regarding the publication of this manuscript.

Figures

Photo 1
Photo 1
A – Binkhorst iridocapsular lens and capsulotomy shapes. B – Christmas tree capsulotomy. C – Can opener capsulotomy. D – Shimizu capsulotomy. E – Neuhann capsulotomy. F – Utrata forceps. G – Capsulotomy with trypan blue stained capsule. H – Tassignon capsulotomy ring. I – Verus capsulotomy ring. J – Digital overlay in microscope view. K – Asymmetric capsulotomy with posterior capsule opacification. L – Imaging during capsulotomy with femtosecond laser. All figures are the property of Richard Packard
Photo 2
Photo 2
A – Scanning EM of femtosecond laser capsulotomy edge. B – Edge of capsulotomy with reduced vertical separation of spots stained with trypan blue. C – Cut edge of capsulotomy disc made with CAPSULaser. D – CAPSULaser attached underneath an operating microscope. E – Anterior (ACC) and posterior capsulotomies (PCC) in a pig eye made with CAPSULaser. F – Zepto in position on the anterior capsule. G – Oculentis Femtis IOL showing anterior minihaptics. All figures are the property of Richard Packard
See this image and copyright information in PMC

References

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