CAPSULAR OPENING CONTRACTION AFTER CONTINUOUS CURVILINEAR CAPSULORHEXIS AND INTRAOCULAR-LENS IMPLANTATION

Purpose: To evaluate the progressive constriction of the anterior caps ule opening that can occur after continuous curvilinear capsulorhexis (CCC). Setting: Kangnam St. Mary's Hospital, Seoul, Korea. Methods: Ch anges in the anterior capsule opening after CCC were evaluated in 166 pseudophakic eyes at 1 week and 1 and 3 months postoperatively. The ca psular opening diameter was measured with an image analysis system. Re sults: The capsular opening diameter was reduced by an average of 13.8 7% 3 months after CCC. There was more dense opacity in the anterior th an in the posterior capsule. Lens epithelial cells (LECs) were the mai n cause of capsule contraction; sex, age, intraocular lens haptic leng th and haptic material, and CCC size did not have a statistically sign ificant effect on capsule shrinkage (P >.05). Three months after surge ry, most eyes with an initial capsular opening diameter of less than 5 .5 mm had an opening diameter smaller than 5.0 mm. In most eyes with a n initial capsular opening larger than 5.5 mm, the opening remained la rger than 5.0 mm. Conclusion: Our results suggest that the ideal CCC s ize is 5.5 to 6.0 mm or larger and that LEC removal is necessary to pr eserve the pupillary zone and thus prevent progressive capsular openin g shrinkage.