Capsulorhexis phymosis following uncomplicated phacoemulsification surgery

PURPOSE: The aim of the study was to assess and compare the degree of capsulorhexis phymosis following uncomplicated phacoemulsification cataract surgery in polymethylmethacrylate (PMMA) and silicone lens implants.

METHOD: Sixty-four patients were evaluated 1 day, 6 weeks and 6 months following phacoemulsification cataract extraction. The anterior capsular diameters were measured with the illuminated beam of the slit lamp at 45 degrees and 135 degrees and the surface area of the opening calculated. We have measured and compared the change in the capsulorhexis size for both lens types and assessed its statistical significance with a paired Student's t-test.

RESULTS: A statistically significant contraction of the capsulorhexis was noted in all patients within the first 6 weeks (p < 0.001). Capsular contraction continued between 6 weeks and 6 months post-operatively but to a lesser extent (p < 0.05). The difference in the degree of phymosis between the first period (1 day to 6 weeks) and the second (6 weeks to 6 months) was statistically highly significant for all patients (p < 0.001). The capsular areas for the silicone lens implants were significantly smaller than for the PMMA implants at 6 weeks and 6 months. None of our patients had a clinically significant capsular contracture requiring Nd:YAG laser capsulotomy.

CONCLUSION: Anterior capsular contraction is commonly observed following capsulorhexis in phacoemulsification surgery. This study demonstrates that the maximum rate of contraction occurs in the first 6 weeks following surgery and is more pronounced with silicone lens implants.