Capsulotomy

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For capsulotomy as a type of neurosurgery, see psychosurgery.
Capsulotomy
Posterior capsular opacification on retroillumination.jpg
Capsular opacification after cataract surgery
ICD-9-CM13.19
MeSHD002387

Capsulotomy (BrE /kæpsjuː'lɒtəmi/, AmE /kæpsuː'lɑːtəmi/)[1] is a type of eye surgery in which an incision is made into the capsule of the crystalline lens of the eye. In modern cataract operations, the lens capsule is usually not removed. The most common forms of cataract surgery remove nearly all of the crystalline lens but do not remove the crystalline lens capsule (the outer “bag” layer of the crystalline lens). The crystalline lens capsule is retained and used to contain and position the intraocular lens implant (IOL).

Before the advent of laser surgery, a tiny knife called a cystotome was used to cut a hole in the center of the lens capsule, thus providing a clear path for light to reach the retina. This procedure thus reduces the opacity of the lens of the eye.

Anterior capsulotomy[]

The removal of anterior lens capsule during cataract surgery is known as anterior capsulotomy. It is one of the most important steps in cataract surgery.[2]

Types[]

Can opener capsulotomy[]

Can opener capsulotomy is done by making a circular opening of 5–6 mm diameter in the anterior capsule, by series of small tears with a cystitome.[2] Jacques Daviel invented this technique in 1752.[2] This technique is commonly done during extracapsular cataract extraction.

Envelope capsulotomy[]

Envelope capsulotomy is done by making a linear incision in upper one-third of anterior capsule.[2] Sourdilla and Baikuff suggested this technique in 1979.[2]

Femtosecond laser-assisted capsulotomy[]

This technique uses femtosecond laser to do capsulotomy.[2]

Plasma blade capsulotomy[]

Plasma blade capsulotomy uses plasma technology to create an incision in anterior capsule.[2]

Precision Pulse Capsulotomy/Zepto[]

Precision Pulse Capsulotomy is a non laser capsulotomy procedure performed using a device with a soft collapsible tip and circular Nitinol cutting element that is connected to a control console.[2]

Posterior capsulotomy[]

Months or years after the cataract operation, the remaining posterior lens capsule can become opaque and vision will be reduced in about 20-25% of eyes.[3] This is known as posterior capsule opacification (PCO). PCO is best treated by posterior capsulotomy using YAG laser.[3]

Complications[]

Retinal detachment, Ocular hypertension and IOL dislocation are the major complications of posterior capsulotomy.[4]

References[]

  1. ^ "Medical Definition of CAPSULOTOMY". www.merriam-webster.com.
  2. ^ a b c d e f g h Sharma, Bhavana; Abell, Robin G; Arora, Tarun; Antony, Tom; Vajpayee, Rasik B (2019). "Techniques of anterior capsulotomy in cataract surgery". Indian Journal of Ophthalmology. 67 (4): 450–460. doi:10.4103/ijo.IJO_1728_18. PMC 6446625. PMID 30900573.
  3. ^ a b Salmon, John F. (2020). Kanski's clinical ophthalmology : a systematic approach (9th ed.). [Edinburgh]. p. 331. ISBN 978-0-7020-7713-5. OCLC 1131846767.
  4. ^ Kierstan Boyd (29 October 2020). "What Is a Posterior Capsulotomy?". American Academy of Ophthalmology.

Further reading[]

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