Abstract
In this report we describe the surgical details involved in refilling the lenses of 13 rabbit and 3 primate eyes using an inflatable endocapsular balloon to restore accommodation. The procedure involves endocapsular phacoemulsification through a small “buttonhole” or “dumbbell” anterior capsulotomy or minicircular capsulotomy and the simultaneous preservation of capsular integrity, including the zonules and ciliary muscles. An inflatable balloon made of thin silicone membrane is then inserted into the empty capsular bag. A liquid silicone polymer is injected into the balloon through a delivery tube, and the empty capsular bag is refilled by the inflated balloon. The procedure was found to be reproducible, and an accommodation of 6 D was confirmed in one primate eye. Capsular opacification occurred, but the proliferation and migration of residual lens epithelial cells could be hindered by abundant refilling. This lens-refilling technique may provide restoration of accommodation in future cataract surgery.
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References
Apple DJ, Mamalis N, Olson RJ, Kincaid MC (1989) Intraocular lenses. Evolution, designs, complications and pathology. Williams and Wilkins, Baltimore, pp 201–203
Gindi JJ, Wan WL, Schanzlin DJ (1985) Endocapsular cataract surgery. I. Surgical technique. Cataract 2:6–10
Haefliger E (1989) Phaco-ersatz: the injectable lens key surgical problems. In: Buratto L (ed) Extracapsular cataract microsurgery. Centro Ambrosiano Microchirurgica Oculare, Milano, pp 678–686
Haefliger E, Parel JM, Fantes F, Norton E, Anderson DR, Forster RK, Hernandez E, Feuer WJ (1987) Accommodation of an endocapsular silicone lens (Phacoersatz) in the nonhuman primate. Ophthalmology 94:471–477
Hara T, Hara T (1989) Electric microtrephine for small size tear-free anterior capsular openings. Atarashii Ganka (J Eye) 6:1595–1598
Machemer R, Aaberg TM (1979) Vitrectomy, 2nd edn. Current ophthalmology monographs. Grime and Stratton, New York, pp 125–134
Nishi O (1989) Refilling the lens of the rabbit eye after intercapsular cataract surgery using an endocapsular balloon and an anterior capsule suturing technique. J Cataract Refract Surg 15:450–454
Nishi O (1989) Intercapsular cataract surgery with lens epithelial cell removal. I. Without capsulorhexis. J Cataract Refract Surg 15:297–300
Nishi O (1990) Micropunch for buttonhole anterior capsulotomy in endo-intercapsular cataract surgery. Arch Ophthalmol 108:892–893
Nishi O, Nishi K (1990) Endocapsular phacoemulsification, following buttonhole anterior capsulotomy. A preliminary report. J Cataract Refract Surg 16:757–762
Nishi O, Hara T, Hara T, Hayashi F, Sakka Y, lwata S (1989) Further development of experimental refilling of the lens of animal eyes with a balloon. J Cataract Refract Surg 15:584–588
Parel JM, Gelender H, Treffers WF, Norton EWD (1986) Phacoersatz: cataract surgery designed to preserve accommodation. Graefe's Arch Clin Exp Ophthalmol 224:165–173
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Nishi, O., Hara, T., Hara, T. et al. Refilling the lens with an inflatable endocapsular balloon: surgical procedure in animal eyes. Graefe's Arch Clin Exp Ophthalmol 230, 47–55 (1992). https://doi.org/10.1007/BF00166762
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DOI: https://doi.org/10.1007/BF00166762