Endocapsular Cataract Surgery Following Small Circular Capsulorhexis

Using an anterior chamber maintainer to control intraocular pressure during phacoemulsification

We describe a phacoemulsification technique that uses an anterior chamber maintainer (ACM) to control intraocular pressure. Continuous irrigation through the ACM maintains pressurized intraocular conditions throughout surgery and when the automated system is not activated. Intraocular pressure is stabilized at predetermined levels with minor fluctuations. Viscoelastics can be used in conjunction with the ACM.

Anterior capsule-supported intraocular lens. A new lens for small-incision surgery and for sealing the capsular opening

A new intraocular lens made of PMMA and fixed in the anterior capsular opening is introduced. The lens diameter is 4 mm and the lens has no haptics in the conventional sense but is finely grooved around the circumference edge. The lens is inserted into the anterior capsule via a very small-diameter opening created by mini-circular capsulorhexis. The anterior capsular opening, with a round, smooth-edged margin, avoids stress concentration and, therefore, the capsule does not easily tear. This opening catches the lens and chokes it along the grooved edge. In animal experiments, firm fixation was obtained. This lens may be adequate for small-incision surgery, and in the future it may be used to prevent leakage of filling material during refilling of the lens, since it acts as a part of the anterior capsule and seals the capsular opening completely.