Comparative evaluation of anterior lens capsule electron microscopic pathology in a case undergoing simultaneous bilateral cataract surgery: A study of CAPSULaser and continuous curvilinear capsulorhexis

Purpose: To identify ultrastructural changes, such as thermal effects and lens cortex penetration, to assess the potential benefits of CAPSULaser for future use in patients with complex cataract conditions. Observation: Histological examination of the CAPSULaser-treated tissue revealed sections of t...

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Main Authors: Thananop Pothikamjorn, Marisa Prasanpanich, Thanapong Somkijrungroj
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:American Journal of Ophthalmology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2451993625001537
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author Thananop Pothikamjorn
Marisa Prasanpanich
Thanapong Somkijrungroj
author_facet Thananop Pothikamjorn
Marisa Prasanpanich
Thanapong Somkijrungroj
author_sort Thananop Pothikamjorn
collection DOAJ
description Purpose: To identify ultrastructural changes, such as thermal effects and lens cortex penetration, to assess the potential benefits of CAPSULaser for future use in patients with complex cataract conditions. Observation: Histological examination of the CAPSULaser-treated tissue revealed sections of the anterior capsule, cuboidal epithelial cells, and lens cortex collagen fibers. The edges of the tissue were slightly bent toward the anterior side, displaying a thermal effect measuring 62.12 μm in width. The tissue strip showed irregular thickness, with a maximum lens cortex collagen fiber thickness of 237.1 μm. Under TEM, the capsular margins appeared fragmented, exhibiting bulbous edges and a bubbly appearance. In the cauterized areas, electron-dense materials obscured and distorted the attached epithelial cells and lens fibers, in contrast to the preserved central region. Conversely, light microscopy of the CCC specimen showed sharp, well-demarcated edges tapering from anterior to posterior, and it was thinner than the CAPSULaser specimen. Notably, the CCC specimen lacked lens cortex collagen fibers, consisting solely of the anterior capsule and cuboidal epithelial cells. Ultrastructurally, the CCC specimen's edges appeared angulated and well-dermacated. Conclusion and importance: Our study indicates that the cauterized edges of the CAPSULaser specimen tend to fold toward the anterior side, emphasizing the role of collagen phase changes in enhancing tissue elasticity. This study reported both histopathological and TEM findings, particularly for CAPSULaser, offering valuable insights into the microscopic changes in the anterior capsule when comparing CCC and CAPSULaser.
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spelling doaj-art-2791ab95dc0e4582ae4f9c60ea3ac6202025-08-20T04:00:34ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362025-09-013910240010.1016/j.ajoc.2025.102400Comparative evaluation of anterior lens capsule electron microscopic pathology in a case undergoing simultaneous bilateral cataract surgery: A study of CAPSULaser and continuous curvilinear capsulorhexisThananop Pothikamjorn0Marisa Prasanpanich1Thanapong Somkijrungroj2Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandDepartment of Pathology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandCenter of Excellence in Retina, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; Corresponding author. Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873 Rama IV Rd., Pathumwan, Bangkok, 10330, Thailand.Purpose: To identify ultrastructural changes, such as thermal effects and lens cortex penetration, to assess the potential benefits of CAPSULaser for future use in patients with complex cataract conditions. Observation: Histological examination of the CAPSULaser-treated tissue revealed sections of the anterior capsule, cuboidal epithelial cells, and lens cortex collagen fibers. The edges of the tissue were slightly bent toward the anterior side, displaying a thermal effect measuring 62.12 μm in width. The tissue strip showed irregular thickness, with a maximum lens cortex collagen fiber thickness of 237.1 μm. Under TEM, the capsular margins appeared fragmented, exhibiting bulbous edges and a bubbly appearance. In the cauterized areas, electron-dense materials obscured and distorted the attached epithelial cells and lens fibers, in contrast to the preserved central region. Conversely, light microscopy of the CCC specimen showed sharp, well-demarcated edges tapering from anterior to posterior, and it was thinner than the CAPSULaser specimen. Notably, the CCC specimen lacked lens cortex collagen fibers, consisting solely of the anterior capsule and cuboidal epithelial cells. Ultrastructurally, the CCC specimen's edges appeared angulated and well-dermacated. Conclusion and importance: Our study indicates that the cauterized edges of the CAPSULaser specimen tend to fold toward the anterior side, emphasizing the role of collagen phase changes in enhancing tissue elasticity. This study reported both histopathological and TEM findings, particularly for CAPSULaser, offering valuable insights into the microscopic changes in the anterior capsule when comparing CCC and CAPSULaser.http://www.sciencedirect.com/science/article/pii/S2451993625001537CAPSULaserContinuous curvilinear capsulorhexisCataract surgeryAnterior lens capsuleTransmission electron microscopyHistopathology
spellingShingle Thananop Pothikamjorn
Marisa Prasanpanich
Thanapong Somkijrungroj
Comparative evaluation of anterior lens capsule electron microscopic pathology in a case undergoing simultaneous bilateral cataract surgery: A study of CAPSULaser and continuous curvilinear capsulorhexis
American Journal of Ophthalmology Case Reports
CAPSULaser
Continuous curvilinear capsulorhexis
Cataract surgery
Anterior lens capsule
Transmission electron microscopy
Histopathology
title Comparative evaluation of anterior lens capsule electron microscopic pathology in a case undergoing simultaneous bilateral cataract surgery: A study of CAPSULaser and continuous curvilinear capsulorhexis
title_full Comparative evaluation of anterior lens capsule electron microscopic pathology in a case undergoing simultaneous bilateral cataract surgery: A study of CAPSULaser and continuous curvilinear capsulorhexis
title_fullStr Comparative evaluation of anterior lens capsule electron microscopic pathology in a case undergoing simultaneous bilateral cataract surgery: A study of CAPSULaser and continuous curvilinear capsulorhexis
title_full_unstemmed Comparative evaluation of anterior lens capsule electron microscopic pathology in a case undergoing simultaneous bilateral cataract surgery: A study of CAPSULaser and continuous curvilinear capsulorhexis
title_short Comparative evaluation of anterior lens capsule electron microscopic pathology in a case undergoing simultaneous bilateral cataract surgery: A study of CAPSULaser and continuous curvilinear capsulorhexis
title_sort comparative evaluation of anterior lens capsule electron microscopic pathology in a case undergoing simultaneous bilateral cataract surgery a study of capsulaser and continuous curvilinear capsulorhexis
topic CAPSULaser
Continuous curvilinear capsulorhexis
Cataract surgery
Anterior lens capsule
Transmission electron microscopy
Histopathology
url http://www.sciencedirect.com/science/article/pii/S2451993625001537
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AT marisaprasanpanich comparativeevaluationofanteriorlenscapsuleelectronmicroscopicpathologyinacaseundergoingsimultaneousbilateralcataractsurgeryastudyofcapsulaserandcontinuouscurvilinearcapsulorhexis
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