Contração capsular pós capsulorrexis: relato de casos

Grimberg, Aliana; Kwitko, Sérgio

doi:10.5935/0004-2749.19950033

RESUMO

Um número crescente de cirurgiões vem realizando extração da catarata por facoemulsificação, e assim a capsulorrexis circular contínua tem significativamente aumentado de popularidade. Tem-se observado recentemente uma complicação desta técnica de capsulotomia anterior que é a contração capsular, raramente encontrada em capsulotomias tipo “abridor de lata”. Suas consequências incluem a diminuição extrema da abertura capsular anterior, deslocamento da abertura capsular, redução do diâmetro capsular equatorial e deslocamento da lente intra-ocular, complicações estas encontradas mais freqüentemente em capsulorrexis muito pequenas, pacientes idosos, portadores da Síndrome de pseudo-esfoliação e/ou uveíte anterior severa. Apresentamos aqui 3 casos de contração da abertura capsular anterior após capsulorrexis em facoemulsificação, um deles com deslocamento da lente intra-ocular.

Palavras-chave:
Capsulorrexis; Contração Capsular; Facoemulsificação

SUMMARY

As phacoemulsification has been gained space among cataract surgeons, continuous circular capsulorhexis has also been performed more frequently. A complication of this technique has been recently observed, that is, capsule contraction syndrome, which rarely develop in can-opener capsulectomies. Undesired effects of such contraction are the extreme reduction of capsulectomy opening, malpositioning of the opening, reduction in equatorial capsular diameter, and displacement of intraocular lens. These complications occur more frequently in small capsulorhexis openings, older patients, pseudoesfoliation syndrome and/or in eyes with severe uveitis. We report herein 3 cases of a capsule contraction syndrome after capsulorhexis in phacoemulsification, one of them developing intraocular lens displacement.

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REFERÊNCIAS BIBLIOGRÁFICAS

¹
GIMBEL, H.V. & NEUHANN, T. - Development, advantages, and methods of the continuous capsulorhexis technique. J Cataract Refr Surg, 16: 31, 1990.
²
GIMBEL, H.V. & NEUHANN, T. - Continuous curvilinear capsulorhexis. J Cataract Refr Surg, 17: 110, 1991.
³
COLVARD, D.M. & DUNN, S.A. - Intraocular lens centration with continuous tear capsulotomy. J Cataract Refr Surg, 16:312, 1990.
⁴
WASSERMAN, D.; APPLE, D.J.; CASTANEDA V.E. et al. - Anterior capsular tears and loop fixationn of posterior chamber intraocular lenses. Ophthalmology, 98: 425, 1991.
⁵
HANSEN S.O.; CRANDALL A.S. and OLSON R.J. - Progressive constriction of the anterior capsular opening following intact capsulorhexis. J Cataract Refr Surg, 19: 77, 1993.
⁶
DAVISON J.A. - Capsule contraction syndrome. J Cataract Refr Surg, 19: 582, 1993.
⁷
GHIARONI, A. & DAHER L. - Síndrome de contração capsular. Rev Bras Oftalmol, 53: 69,1994.
⁸
ALMALLAH O.F. - Capsulorhexis complications with planned extracapsular cataract extraction. J Cataract Refr Surg, 15: 232, 1989. [letter]
⁹
BELFORT, Jr.; NUSSEMBLAT, R.; LOTTEMBERG, C.; KWITKO, S.; CHAMON W. de; SMET M.; RUBIN, B. - Spontaneous Lens Subluxation in Uveitis. Am J Ophthalmol, 110: 714,1990. [letter]
¹⁰
TSUBOI S.; TSUJIOKA M. & KOJIMA S. - Effect of continuous circular capsulorhexis and intraocular lens fixation on the blood-aqueous barrier. Arch Ophthalmol, 110: 1124, 1992.
¹¹
NISHI O. - Intercapsular cataract surgery with lens epithelial cell removal. Part II: effect on prevention of fibrinous reaction. J Cataract Refr Surg, 15: 301, 1989.
¹²
FREZZOTTI, R.; CAPOROSSI, A.; MASTRAN-GELO D. et al. - Pathogenesis of posterior capsular opacification. Part II: histopathological and in vitro culture findings. J Cataract Refr Surg 16: 353, 1990.
¹³
DAVISON J.A. - Capsular bag distension after endophacoemulsification and posterior intraocular lensimplantation. J Cataract Refr Surg 16: 99, 1990.
¹⁴
DAVISON J.A. - Structural features of intraocular lenses designed for use after capsulorhexis. J Cataract Refr Surg, 19: 112, 1993. [letter]

Datas de Publicação

Publicação nesta coleção
Oct 1995

Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que o trabalho original seja corretamente citado.

[1] ¹
GIMBEL, H.V. & NEUHANN, T. - Development, advantages, and methods of the continuous capsulorhexis technique. J Cataract Refr Surg, 16: 31, 1990.

[2] ²
GIMBEL, H.V. & NEUHANN, T. - Continuous curvilinear capsulorhexis. J Cataract Refr Surg, 17: 110, 1991.

[3] ³
COLVARD, D.M. & DUNN, S.A. - Intraocular lens centration with continuous tear capsulotomy. J Cataract Refr Surg, 16:312, 1990.

[4] ⁴
WASSERMAN, D.; APPLE, D.J.; CASTANEDA V.E. et al. - Anterior capsular tears and loop fixationn of posterior chamber intraocular lenses. Ophthalmology, 98: 425, 1991.

[5] ⁵
HANSEN S.O.; CRANDALL A.S. and OLSON R.J. - Progressive constriction of the anterior capsular opening following intact capsulorhexis. J Cataract Refr Surg, 19: 77, 1993.

[6] ⁶
DAVISON J.A. - Capsule contraction syndrome. J Cataract Refr Surg, 19: 582, 1993.

[7] ⁷
GHIARONI, A. & DAHER L. - Síndrome de contração capsular. Rev Bras Oftalmol, 53: 69,1994.

[8] ⁸
ALMALLAH O.F. - Capsulorhexis complications with planned extracapsular cataract extraction. J Cataract Refr Surg, 15: 232, 1989. [letter]

[9] ⁹
BELFORT, Jr.; NUSSEMBLAT, R.; LOTTEMBERG, C.; KWITKO, S.; CHAMON W. de; SMET M.; RUBIN, B. - Spontaneous Lens Subluxation in Uveitis. Am J Ophthalmol, 110: 714,1990. [letter]

[10] ¹⁰
TSUBOI S.; TSUJIOKA M. & KOJIMA S. - Effect of continuous circular capsulorhexis and intraocular lens fixation on the blood-aqueous barrier. Arch Ophthalmol, 110: 1124, 1992.

[11] ¹¹
NISHI O. - Intercapsular cataract surgery with lens epithelial cell removal. Part II: effect on prevention of fibrinous reaction. J Cataract Refr Surg, 15: 301, 1989.

[12] ¹²
FREZZOTTI, R.; CAPOROSSI, A.; MASTRAN-GELO D. et al. - Pathogenesis of posterior capsular opacification. Part II: histopathological and in vitro culture findings. J Cataract Refr Surg 16: 353, 1990.

[13] ¹³
DAVISON J.A. - Capsular bag distension after endophacoemulsification and posterior intraocular lensimplantation. J Cataract Refr Surg 16: 99, 1990.

[14] ¹⁴
DAVISON J.A. - Structural features of intraocular lenses designed for use after capsulorhexis. J Cataract Refr Surg, 19: 112, 1993. [letter]

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