Haptic Reposition with Laser Posterior Capsulotomy in Eyes with Capsular Contraction without Anterior Capsular Phimosis

Abstract

Capsular contraction (CC) is one of the important complication of the cataract surgery. In rare cases, CC may cause intraocular lens (IOL) decentration, dislocation or dysmorphology. 64 year-old patient underwent cataract surgery nearly 8 months ago, presented with decreased vision due to CC and full flexion of the inferior haptic onto the posterior optic surface of the single piece hydrophylic acrylic IOL. We treated this unusual complication with neodymium:yttrium-aliminum-garnet (Nd:YAG) laser posterior capsulotomy without any surgical manipulation. Folded inferior haptic of IOL was immediately repositioned after the release of posterior capsular tension. In conclusion, Nd:YAG laser posterior capsulotomy is an effective and minimally invasive treatment method in cases with full haptic flexion onto the posterior optical surface of the IOL.

Airways Surface Liquid and Ion Transport - The Mechanism Maintained Patency

“…ASL seems to be composed of two layers: the lower, periciliary linking (PCL) with the consistency of solsalt, and the more viscous, upper mucus layer, with a consistency of gel. However, some recent studies indicate that ASL may be actually more of a continuous hydrogel [15,24]. The thickness of PCL is usually constant and corresponds to the length of the cilia (3-10μm) [25][26].…”

“…Impaired discharge of residual fluid induces inadequate mucociliary clearance (MCC) and colonization of the epithelium by microorganisms [17,23,39,42]. Electrolyte transport across human airway epithelium, followed by water movement is essential for normal mucociliary clearance and allows the maintenance of the aseptic condition of the respiratory tract [4][5]7,14,21,24,41,43]. The function of epithelial cells is to control and regulate ionic composition and the volume of fluids in the airways [2,4,6,21,24,28,33,36,41,[44][45][46].…”

“…Electrolyte transport across human airway epithelium, followed by water movement is essential for normal mucociliary clearance and allows the maintenance of the aseptic condition of the respiratory tract [4][5]7,14,21,24,41,43]. The function of epithelial cells is to control and regulate ionic composition and the volume of fluids in the airways [2,4,6,21,24,28,33,36,41,[44][45][46]. Therefore, continuous local fluid absorption and secretion following the cephalal ASL motion is necessary to maintain the proper thickness of the fluid lining throughout the entire airway space [2,[6][7]9,14,26,41,43,48].…”

“…Disorders may not only result from disease, but also may be one of the factors contributing to them. For example, disturbed MCC is observed in COPD, asthma, immobile cilia syndrome, cystic fibrosis and chronic bronchitis [9,19,24,35,42,48]. The optimal value of temperature in the tracheobronchial airways is 34-40 °C.…”

“…Regardless of the body's position, the direction of mucus transport is always cephalic and depends on the unchanging beats of cilia [9,15]. The composition and quantity of ASL, as well as the fluid movement is influenced by a number of internal and external factors, including drugs [9,15,22,[24][25]. The aim of this study was to collect reliable scientific data concerning physiological and pathological changes in ASL volume and composition.…”