Complication from combined use of capsule retractors and capsular tension rings in zonular dehiscence.

Unlabelled: We describe a new complication associated with capsular tension ring (CTR) implantation after placement of capsule retractors. We report 3 cases from 3 different surgeons of inadvertent threading of a CTR through a capsule retractor loop. In each case, the distal loop was opened or amputated to facilitate hook removal.

Single suture iris-to-capsulorhexis fixation for in-the-bag intraocular lens subluxation.

Unlabelled: We present a simplified modification to a technique for early or mild in-the-bag subluxation that avoids conjunctival and scleral incisions and minimizes intraocular manipulation. While the capsulorhexis edge is grasped with an intraocular forceps to stabilize the IOL-capsular bag complex, a 10-0 polypropylene suture on a long curved needle is used to secure the fibrotic superior capsulorhexis edge to the midperipheral iris at 12 o'clock using a combination of a modified McCannel suture and a Siepser sliding knot.

Financial Disclosure: Dr.

Minimizing the invasiveness of traditional trabeculectomy surgery.

Unlabelled: Microinvasive invasive glaucoma surgery has become increasingly popular as a surgical alternative for glaucoma. Although the time-honored trabeculectomy remains the unrivaled contender for lowering intraocular pressure (IOP) into the single digits, newer devices are available that attempt to reach similar IOP levels with fewer complications and quicker visual recovery. The Express mini-shunt and the Innfocus microshunt are 2 devices that bring us closer to the goal of repeatable, lower risk surgery; improved patient satisfaction; stabilization of the visual field; and long-term IOP control.

Modified Wise closure of the conjunctival fornix-based trabeculectomy flap.

We present modifications to the Wise fornix-based conjunctival trabeculectomy flap technique that have minimized early wound leakage in our experience. A retrospective chart review of 509 consecutive eyes revealed a 2.9% leak rate in the first postoperative month and 1.

Randomized, prospective, comparative trial of EX-PRESS glaucoma filtration device versus trabeculectomy (XVT study).

Purpose: To compare the clinical outcomes of the EX-PRESS glaucoma filtration device placed under a partial-thickness scleral flap with trabeculectomy.

Design: Randomized, prospective, multicenter trial.

Methods: A total of 120 eyes in 120 subjects were analyzed, including 59 eyes treated with EX-PRESS and 61 eyes treated with trabeculectomy.

Simplified ab externo scleral fixation for late in-the-bag intraocular lens dislocation.

Many surgical techniques to repair late in-the-bag intraocular lens (IOL) dislocation have been described. We present a modification to ab externo scleral fixation of in-the-bag IOL dislocation that minimizes cumbersome intraocular manipulations. Using an iris hook for intraocular suture retrieval under direct visualization eliminates the need to mate the suture needle with a hypodermic needle, and the site through which the hook is used provides an ideal place for suture knot burial, potentially minimizing late suture erosion or exposure.

Ultrasound biomicroscopic analysis of iris-sutured foldable posterior chamber intraocular lenses.

Purpose: To report ultrasound biomicroscopic (UBM) findings of iris-sutured foldable posterior chamber intraocular lenses (PCIOLs).

Design: Prospective, noninterventional consecutive case series.

Methods: Fifteen eyes with foldable acrylic IOL implantation using peripheral iris suture fixation in the absence of capsular support were included.

Small-incision iris fixation of foldable intraocular lenses in the absence of capsule support.

Purpose: To report visual outcomes and complications of modified McCannel iris suture fixation of small-incision foldable acrylic intraocular lenses (IOLs) for aphakia in the absence of capsule support.

Design: Retrospective interventional case series.

Participants: Forty-six patients who underwent foldable acrylic IOL implantation using peripheral iris suture fixation for aphakia in the absence of capsule support.

Late in-the-bag intraocular lens dislocation: incidence, prevention, and management.

Dislocation of an intraocular lens (IOL) with the capsular bag is a late complication of cataract surgery, reported with increasing frequency in recent years. Pseudoexfoliation, uveitis, myopia, and other diseases associated with progressive zonular weakening and capsular contraction are the predisposing conditions. Capsular tension rings probably help but do not prevent this complication.

Simplified small-incision peripheral iris fixation of an AcrySof intraocular lens in the absence of capsule support.

In the absence of capsule and zonule support, a modified insertion technique allows simple peripheral iris fixation of a posterior chamber 3-piece acrylic intraocular lens (IOL) via a small incision for secondary implantation. A bimanual unfolding maneuver creates pupillary capture of the optic to temporarily stabilize the IOL. Peripheral modified McCannel sutures fixate the flexible monofilament poly(methyl methacrylate) haptics to the posterior peripheral iris surface, after which the optic is safely prolapsed into the posterior chamber.

Efficacy and safety of mitomycin-C in primary trabeculectomy: five-year follow-up.

Purpose: To examine the 5-year complications and results of primary trabeculectomy with mitomycin-C (MMC).

Design: Retrospective, noncomparative interventional case series.

Participants: One hundred twenty-three eyes that underwent primary trabeculectomy with MMC between December 1991 and March 1995.