New device for creating a continuous curvilinear capsulorhexis.
OBJECTIVE
To describe the evolution of a new device to facilitate continuous curvilinear capsulorhexis (CCC) creation.


METHODS
Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA.


METHODS
Experimental study.


METHODS
Bench-side ex vivo testing of unique prototypes for guidance and assistance of CCC in bovine and human eyes was performed. Five designs were sequentially tested as follows: a flexible circular blade of nickel-titanium alloy (nitinol), a flexible nitinol guide wire, a flexible elastomeric suction device, a combination approach of a nitinol guide wire and flexible silicone ring, and a freestanding micropatterned silicone ring.


RESULTS
The first 3 designs were not amenable to insertion through a sub-2.4 mm corneal incision and failed to maintain adequate downward force to cut the capsule and/or prevent radial tears. The fourth design was successfully inserted through a 2.4 mm incision and maintained adequate downward pressure and contact to guide a manual CCC without radial tears. The final design was insertable through a 2.4 mm incision and exhibited self-adhesive characteristics after placement on the anterior capsule of an ophthalmic viscosurgical device-filled anterior chamber.


CONCLUSIONS
Given the steep learning curve of manual capsulorhexis and the high cost of capsulotomy-assistive devices, such as the femtosecond laser, an alternative approach for creating a CCC is desirable. Performance of a highly precise manual CCC through a small incision using a medical-grade silicone device with an adhesive micropatterned design is a viable and cost-effective option for use in cataract surgery across a wide range of user experience.


BACKGROUND
All authors are named as the inventors in a patent filed by the University of Colorado covering the details in this report.
From the Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA.
Matthew A
MA
Powers
From the Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA. Electronic address: malik.kahook@ucdenver.edu.
Malik Y
MY
Kahook
D000818:Animals; D019923:Capsulorhexis / Q000295:instrumentation*; D002417:Cattle; D004867:Equipment Design; D006801:Humans; D007908:Lens, Crystalline / Q000601:surgery*; D009532:Nickel; D014025:Titanium; D055675:Viscosupplements
D055675:Viscosupplements; C040654:titanium nickelide; D009532:Nickel; D014025:Titanium