Limbus-centered marking technique-assisted continuous circular capsulorhexis

Abstract

To introduce a limbus-centered continuous circular capsulorhexis (CCC) marking technique.Compared with traditional capsulotomy diameter mark technique, a self-designed limbus-centered capsulotomy mark (LCM) was used to perform the routine cataract surgery in this observational study. Ten eyes were included in each group. The area outer/inner 5.5-mm CCC ring, the furthest/nearest distance from the capsule margin to the intraocular lens (IOL) margin, the CCC total coverage IOL area were measured and compared between this 2 groups.No significant differences were found for all the comparison parameters between the 2 groups (all P > .05). However, the capsule total coverage area, area inner 5.5-mm ring was lower in the LCM group, which demonstrated advantage of LCM.The limbus-centered capsulotomy diameter mark, as an inexpensive and convenient method, helps to perform limbus-centered capsulorhexis with not only a 360° overlapping capsular edge but also well-centered IOL optics.

Figure 1

The degree of inconsistency between corneal center (red circle and red crisscross line) and dilated pupil center (green circle and green crisscross line) in different surgical eyes.

Figure 2

(Minghui Deng) The limbus-centered colored indentation is marked on the corneal surface using the limbus-centered capsulotomy mark (LCM). Note: 1) the toric manual marker is applied on the opposite side of the corneal mark to make sure that the indentation mark is more distinct (top left); 2) the LCM device is combined with the capsulotomy diameter mark device using an astigmatism marker plate, keeping the distance from the inner ring margin to the horizontal and vertical limbus equal to make sure that LCM is well-centered at the limbus as a reference during the surgery (top right); 3) after indentation, coaxially sighted corneal reflex is confirmed to be centered in the corneal indentation circle, and the 0–180° horizontal line passes through it.

Figure 3

(Minghui Deng) Anterior capsulotomy inside the limbus-centered capsulotomy mark indentation and the finished continuous circular capsulorhexis margin following the indentation.

Figure 4

(Minghui Deng) After phacoemulsification and cortex removal, the continuous circular capsulorhexis margin is identical with the indentation (top left), and the well-centered intraocular lens (IOL) and capsule overlap after IOL implantation with a 6.0-mm optical diameter during the surgery (top right). After 1 postoperative week, the intraocular lens was well-centered, and the anterior capsule margin evenly covered the IOL optic edges.

Figure 5

The area outer/inner 5.5-mm CCC ring (the irregular area circled by the ideal 5.5-mm CCC ring and the actual CCC margin demonstrated with the red and green arrows), the furthest/nearest distance from the capsule margin to the IOL margin (6.0 mm ring), the CCC total coverage IOL area (the area between IOL optic margin and the actual CCC margin) were measured for final analysis.

Figure 6

Total coverage area of each case in CDM group (blue rectangle) and LCM group (green rectangle).