Capsular stabilization device to preserve lens capsule integrity during phacoemulsification with a weak zonule

Abstract

We describe a new capsular stabilization device for suspending a lens with weak zonular support. It is flexible, 10.0 mm in length, and fashioned from 5-0 nylon. The contact portion is bent at 1.25 mm with an end bifurcating to form a T-shape to minimize stress on the capsular equator. After a continuous curvilinear capsulorhexis is created, the capsular stabilization devices to hook the capsulotomy margin are inserted. The T-shaped end is passed around the anterior capsular flap to fit the curvature of the equator. Phacoemulsification and aspiration using this device was performed in 12 eyes of 9 patients, and the usefulness and complications were analyzed. The capsular stabilization devices suspended the capsule and facilitated safe phacoemulsification in all eyes. Posterior capsule rupture occurred in 2 eyes. None of the cases had notable postoperative complications. This device ensures a stable capsule-iris complex and reduces surgical risks.

Categorization and Surgical Techniques of Weak Zonule Based on Findings at Capsulorhexis during Cataract Surgery

“…This categorization is reliable because it is based on findings from a single surgeon who performed the same CCC procedure for each surgery. In addition, we had previously reported using a CE [5] and M-CE [9] to demonstrate their usefulness in cases with weak zonules.…”

“…We had developed a CE to preserve the lens capsule integrity during PEA procedures performed on eyes with weak zonules [5]. The CE is flexible, 10 mm long, and fashioned from 5-0 polypropylene.…”

“…Since its introduction, several types of endocapsular support devices have been developed, and iris retractors have been used for capsular stabilization in cases of zonular compromise [2][3][4]. We recently developed the T-shaped capsular hook (capsule expander TM ; CE, Handaya, Japan), and have reported its usefulness during PEA in cases with weak zonules [5].…”

Glued endocapsular hemi-ring segment for fibrin glue–assisted sutureless transscleral fixation of the capsular bag in subluxated cataracts and intraocular lenses

“…Microhooks in the form of iris retractors 10,11 and capsule stabilization devices such as the Mackool capsular retractor 12,13 or the device described by Nishimura et al 14 were proposed for capsular bag stabilization during cataract surgery to avoid stress on the remaining zonular apparatus during the steps of phacoemulsification. Capsular tension segments such as the Ike segments 15,B and the Assia anchors 16 can be inserted at any time during surgery for intraoperative support and are sutured onto the scleral wall with 9-0 or 10-0 polypropylene (Prolene) sutures for intraoperative and postoperative support and centration of the capsular bag.…”

Repositioning and scleral fixation of subluxated lenses using a T-shaped capsule stabilization hook

“…[3][4][5] We reported the use of a T-shaped capsule hook (capsule expander [CE], Handaya Co., Ltd.) to suspend and stabilize the lens capsule and facilitate safe phacoemulsification. 6 The CE provides intraoperative stability and fixation of the lens capsule, but this device is temporary. We have designed a new T-shaped capsule hook (modified capsule expander [M-CE], Handaya Co., Ltd.) to permanently fixate the lens capsule to the sclera.…”