Background: We investigated long-term safety and efficacy of sealed capsule irrigation (SCI) during cataract surgery to prevent posterior capsule opacification (PCO). Methods: One eye of each of 17 patients (mean age: 70.1¡9.7 years) who presented with bilateral cataracts was randomly chosen for SCI treatment. After phacoemulsification, the capsular bag was vacuum sealed with the PerfectCapsule device (Milvella) followed by SCI using distilled water for two minutes. No vacuum loss occurred during irrigation. Each patient's fellow eye served as a control. One hydrophilic acrylic intraocular lens model was implanted in all eyes. Five patients had to be excluded due to deep anterior chamber, small pupil or unilateral surgery. Follow-up examinations took place one day and one, three, six, 12 and 24 months after surgery. We evaluated safety parameters, anterior capsule (AC) overlapping and PCO. Results: Postoperatively, mean best corrected visual acuity, pachymetry, endothelial cell count, intraocular pressure, AC overlapping and PCO showed no statistically significant difference between SCI and the control group (p.0.05, Wilcoxon test). Conclusion: SCI is a safe procedure and enables the specific pharmacological targeting of lens epithelial cells inside the capsular bag. Using distilled water, however, it is not possible to reduce PCO development significantly. Thus, alternative substances should be evaluated.

Purpose To evaluate intraocular lens (IOL) power calculation using ray tracing in patients presenting with cataract after excimer laser surgery. Methods Ten eyes of seven consecutive patients who presented for cataract surgery following excimer laser treatment without any pre-refractive biometry data were enrolled in this prospective clinical study. Preoperatively, IOL power calculation was performed using a ray tracing software called OKULIX. Keratometry data (C-Scan) were imported and axial length (IOLMaster) was entered manually. Accuracy of IOL power calculation was investigated by subtracting attempted and achieved spherical equivalent. Conclusions IOL power calculation after excimer laser surgery can be difficult, especially when pre-refractive keratometry values are not available. In these cases, ray tracing combined with corneal topography measurements provides reliable and satisfactory postoperative results. However, it is advisable to be careful when calculating IOL power for eyes with corneal radii exceeding 10 mm because of slightly higher prediction errors.

PURPOSE: Corneal radii (R1, R2) and anterior chamber depth are important parameters for biometry and refractive surgery. This study aimed to investigate whether the IOLMaster, a biometric device, and the Pentacam, a rotating Scheimpflug camera, provide comparable results. METHODS: In this prospective study, corneal radii and anterior chamber depth were analyzed in 82 eyes of 41 phakic patients (median age 72 years) using the IOLMaster and Pentacam. Normal distribution was confirmed using the Kolmogorov-Smirnov test. A paired t test was used for statistical analysis. RESULTS: No statistically significant difference was noted for R2 using the Pentacam versus the IOLMaster (P=.40). There was a small statistical difference of 0.03 mm (P<.01) for R1 (corresponding to 0.08 diopters [D]). The IOLMaster measured a mean R1 of 7.87 mm and R2 of 7.67 mm. The Pentacam measured mean R1 of 7.90 mm and R2 of 7.69 mm. For anterior chamber depth values, a small statistically significant difference of 0.05 mm (P<.001) was found (corresponding to 0.01 D). Mean anterior chamber depth measured from the epithelium was 3.20 mm for the IOLMaster and 3.25 mm for the Pentacam. The Bland-Altman plot showed no distorting trends for either variable. CONCLUSIONS: Keratometry and anterior chamber depth were comparable for the two devices. If the axial length is known, the Pentacam can be used as a biometric device. [J Refract Surg. 2007;23:368-373.]

The C-flex IOLs showed good functional results and significantly lower PCO formation than the earlier model Centerflex IOL. The enhanced edge of the C-flex IOL seemed to improve PCO prevention clinically.