Cystoid macular oedema after extracapsular cataract extraction and intraocular lens implantation in diabetic patients without retinopathy.

Postoperative onset or aggravation of cystoid macular oedema (CMO) in diabetic patients after extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation is a frequent problem. At present little is known about the occurrence and prognosis of this complication in diabetics with no clinically detectable diabetic retinopathy (DR). Twenty five diabetic eyes (24 subjects) without DR and 45 normal eyes (44 subjects) were studied before surgery and 30, 90, 180, 360 days after ECCE and posterior chamber IOL implantation. Fluorescein angiography was performed at each examination. The frequency of angiographic CMO in the two groups was comparable 30 days after surgery but was significantly higher in diabetic eyes at 90, 180, and 360 days. This finding is probably related to an impairment of the blood-retinal barrier in diabetics. Final visual acuity, however, was similar in the two groups.     

Use of capsular tension ring in phacoemulsification. Indications and technique

The capsular tension ring (CTR) was originally introduced to reinforce the zonule in eyes with zonular dehiscence and to prevent capsular phimosis in eyes at risk for postoperative capsular shrinkage. Since then, other designs and applications have been developed and described. Modified CTRs with shields can be used in eyes with iris coloboma. A CTR with loops is intended for scleral fixation. Studies are underway to determine if the presence of the CTR helps avoid or limit capsular opacification. A number of different insertion techniques with the aid of manipulators, injectors and traction sutures have been described. We have developed a technique that is particularly effective in cases of zonular dehiscence due to its low solicitation to the damaged bag.