Measuring the anterior capsule opening after cataract surgery to assess capsule shrinkage

Purpose: To measure anterior capsule opening (ACO) size after acrylic intraocular lens (IOL) implantation and study the natural course of ACO reduction. Setting: Kimura Eye and Internal Medicine Hospital, Hiroshima, Japan. Methods: This study comprised 32 patients (38 eyes): halving continuous curvilinear capsulorhexis, phacoemulsification, acrylic IOL implantation, and a self-seallng incision performed by 1 surgeon. A retroillumination photograph of the ACO was obtained with the Anterior Eye Segment Analysis System and converted to a computer image. The images were used to measure ACO size postoperatively and j calculate the reduction ratio. Follow-up was 6 months. Results: The postoperative reduction ratio in ACO size was 2.14% at 1 week, 3.83% at i month, 4,29% at 3 months, and 5.03% at 6 months. In a few cases, the reduction was progressively severe throughout the follow-up. Concluslons: The anterior capsule opening shrank rapidly during thefirst month after acrylic IOL implantation, followed by a slower progressive reduction in the subsequent 6 months. When severe, progressive shrinkage occurs, an anterior neodymium;YAG laser capsulotomy should be performed within 2 months postoperatively.