Powers MA, Kahook MY. New device for creating a continuous curvilinear capsulorhexis.
J Cataract Refract Surg 2015;
40:822-30. [PMID:
24767915 DOI:
10.1016/j.jcrs.2013.10.041]
[Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 08/08/2013] [Accepted: 10/12/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE
To describe the evolution of a new device to facilitate continuous curvilinear capsulorhexis (CCC) creation.
SETTING
Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA.
DESIGN
Experimental study.
METHODS
Bench-side ex vivo testing of unique prototypes for guidance and assistance of CCC in bovine and human eyes was performed. Five designs were sequentially tested as follows: a flexible circular blade of nickel-titanium alloy (nitinol), a flexible nitinol guide wire, a flexible elastomeric suction device, a combination approach of a nitinol guide wire and flexible silicone ring, and a freestanding micropatterned silicone ring.
RESULTS
The first 3 designs were not amenable to insertion through a sub-2.4 mm corneal incision and failed to maintain adequate downward force to cut the capsule and/or prevent radial tears. The fourth design was successfully inserted through a 2.4 mm incision and maintained adequate downward pressure and contact to guide a manual CCC without radial tears. The final design was insertable through a 2.4 mm incision and exhibited self-adhesive characteristics after placement on the anterior capsule of an ophthalmic viscosurgical device-filled anterior chamber.
CONCLUSIONS
Given the steep learning curve of manual capsulorhexis and the high cost of capsulotomy-assistive devices, such as the femtosecond laser, an alternative approach for creating a CCC is desirable. Performance of a highly precise manual CCC through a small incision using a medical-grade silicone device with an adhesive micropatterned design is a viable and cost-effective option for use in cataract surgery across a wide range of user experience.
FINANCIAL DISCLOSURE
All authors are named as the inventors in a patent filed by the University of Colorado covering the details in this report.
Collapse