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Izuagbe S, Roy J, Chatila A, Hoang LQ, Ea V, Vaish B, Co CM, Ly A, Wu H, Tang L. A 3D in vitro model for assessing the influence of intraocular lens: Posterior lens capsule interactions on lens epithelial cell responses. Exp Eye Res 2024; 244:109940. [PMID: 38782178 DOI: 10.1016/j.exer.2024.109940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 05/19/2024] [Accepted: 05/21/2024] [Indexed: 05/25/2024]
Abstract
Posterior Capsule Opacification (PCO), the most frequent complication of cataract surgery, is caused by the infiltration and proliferation of lens epithelial cells (LECs) at the interface between the intraocular lens (IOL) and posterior lens capsule (PLC). According to the "no space, no cells, no PCO" theory, high affinity (or adhesion force) between the IOL and PLC would decrease the IOL: PLC interface space, hinder LEC migration, and thus reduce PCO formation. To test this hypothesis, an in vitro hemisphere-shaped simulated PLC (sPLC) was made to mimic the human IOL: PLC physical interactions and to assess their influence on LEC responses. Three commercially available IOLs with different affinities/adhesion forces toward the sPLC, including Acrylic foldable IOL, Silicone IOL, and PMMA IOL, were used in this investigation. Using the system, the physical interactions between IOLs and sPLC were quantified by measuring the adhesion force and interface space using an adhesion force apparatus and Optical Coherence Tomography, respectively. Our data shows that high adhesion force and tight binding between IOL and sPLC contribute to a small interface space (or "no space"). By introducing LECs into the in vitro system, we found that, with small interface space, among all IOLs, acrylic foldable IOLs permitted the least extent of LEC infiltration, proliferation, and differentiation (or "no cells"). Further statistical analyses using clinical data revealed that weak LEC responses are associated with low clinical PCO incidence rates (or "no PCO"). The findings support that the in vitro system could simulate IOL: PLC interplays and predict IOLs' PCO potential in support of the "no space, no cells, no PCO" hypothesis.
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Affiliation(s)
- Samira Izuagbe
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Joyita Roy
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Amjad Chatila
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Le Quynh Hoang
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Vicki Ea
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Bhavya Vaish
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Cynthia M Co
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Aaron Ly
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Hongli Wu
- Department of Pharmaceutical Sciences, College of Pharmacy, North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX, 76107, USA
| | - Liping Tang
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA.
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Özdamar Erol Y, Özdemir Yalçınsoy K, Özdal P. The outcomes of cataract surgery in eyes with Fuchs uveitis. J Ophthalmic Inflamm Infect 2023; 13:4. [PMID: 36780022 PMCID: PMC9925659 DOI: 10.1186/s12348-022-00320-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 12/11/2022] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND To evaluate clinical results in eyes undergoing phacoemulsification intraocular lens (IOL) implantation due to Fuchs, uveitis (FU) related complicated cataract. METHODS Post-surgical outcomes of 56 eyes of 55 FU patients were evaluated retrospectively. Three groups were formed according to the IOL model: hydrophilic SAF6125 (Optima fold) acrylic, hydrophobic SN60AT (Alcon), and hydrophobic AAB00 (Abbott). Postoperative posterior capsular opacification (PCO) development and PCO development time, neodymium number: YAG laser posterior capsulotomy rate, giant cell (GC) deposition on the IOL, and the development time of GC deposits were compared among the groups. All patients were followed postoperatively on the 1st day, 1st week, 2nd and 6th weeks, and then at 3-month intervals. RESULTS The hydrophilic SAF6125 IOL was implanted in 10 eyes, hydrophobic SN60AT in 24 eyes and AAB00 IOL in 22 eyes. The mean postoperative follow-up time was 34.1 ± 30.1 (6-144) months. PCO developed in 7 eyes (70%) in the hydrophilic SAF6125 group, 17 eyes (70.8%) in the hydrophobic SN60AT and 13 eyes (59.1%) in the AAB00 group. There was no statistically significant difference among the three IOL groups in the PCO development, the PCO development time and YAG laser capsulotomy rates (P = 0.674, P = 0.111, and P = 0.507, respectively). The PCO development time was significantly longer in the hydrophobic SN60AT than AAB00 group (P = 0.027). GC deposits were detected in 3 eyes (30%) in the hydrophilic SAF6125 group, 7 eyes (29.1%) in the hydrophobic SN60AT and 3 eyes (13.6%) in the AAB00 group. GC deposition and the development time of GC deposits were similar among the three IOL groups (P = 0.575, P = 0.804). At the final follow-up, BCVA was ≥ 20/40 in 41 eyes (73.2%). CONCLUSION The GC deposits and PCO development were the most important problems in these eyes with hydrophilic or hydrophobic IOLs despite good visual and postoperative results. New developments are needed in terms of IOL design or content in eyes with FU.
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Affiliation(s)
- Yasemin Özdamar Erol
- Department of Uveal Diseases, University of Health Science, Ulucanlar Eye Education and Research Hospital, 06240, Ankara, Türkiye.
| | - Kübra Özdemir Yalçınsoy
- Department of Uveal Diseases, University of Health Science, Ulucanlar Eye Education and Research Hospital, 06240 Ankara, Türkiye
| | - Pınar Özdal
- Department of Uveal Diseases, University of Health Science, Ulucanlar Eye Education and Research Hospital, 06240 Ankara, Türkiye
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Zhang Y, Zhang C, Chen S, Hu J, Shen L, Yu Y. Research Progress Concerning a Novel Intraocular Lens for the Prevention of Posterior Capsular Opacification. Pharmaceutics 2022; 14:pharmaceutics14071343. [PMID: 35890240 PMCID: PMC9318653 DOI: 10.3390/pharmaceutics14071343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/12/2022] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
Posterior capsular opacification (PCO) is the most common complication resulting from cataract surgery and limits the long-term postoperative visual outcome. Using Nd:YAG laser-assisted posterior capsulotomy for the clinical treatment of symptomatic PCO increases the risks of complications, such as glaucoma, retinal diseases, uveitis, and intraocular lens (IOL) pitting. Therefore, finding how to prevent PCO development is the subject of active investigations. As a replacement organ, the IOL is implanted into the lens capsule after cataract surgery, but it is also associated with the occurrence of PCO. Using IOL as a medium for PCO prophylaxis is a more facile and efficient method that has demonstrated various clinical application prospects. Thus, scientists have conducted a lot of research on new intraocular lens fabrication methods, such as optimizing IOL materials and design, and IOL surface modification (including plasma/ultraviolet/ozone treatment, chemical grafting, drug loading, coating modification, and layer-by-layer self-assembly methods). This paper summarizes the research progress for different types of intraocular lenses prepared by different surface modifications, including anti-biofouling IOLs, enhanced-adhesion IOLs, micro-patterned IOLs, photothermal IOLs, photodynamic IOLs, and drug-loading IOLs. These modified intraocular lenses inhibit PCO development by reducing the residual intraoperative lens epithelial cells or by regulating the cellular behavior of lens epithelial cells. In the future, more works are needed to improve the biosecurity and therapeutic efficacy of these modified IOLs.
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Affiliation(s)
- Yidong Zhang
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China; (Y.Z.); (C.Z.); (S.C.); (J.H.); (L.S.)
| | - Chengshou Zhang
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China; (Y.Z.); (C.Z.); (S.C.); (J.H.); (L.S.)
| | - Silong Chen
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China; (Y.Z.); (C.Z.); (S.C.); (J.H.); (L.S.)
| | - Jianghua Hu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China; (Y.Z.); (C.Z.); (S.C.); (J.H.); (L.S.)
- Jiande Branch, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Lifang Shen
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China; (Y.Z.); (C.Z.); (S.C.); (J.H.); (L.S.)
| | - Yibo Yu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, China; (Y.Z.); (C.Z.); (S.C.); (J.H.); (L.S.)
- Correspondence:
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Tortolano L, Mrad O, Manerlax K, Khalfoun C, Yousfi R, Saunier J, Secretan P, Yagoubi N. Comparative stability of intraocular lenses during 2–20 years of artificial aging, potential effects in terms of biocompatibility. J Appl Polym Sci 2022. [DOI: 10.1002/app.52752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Lionel Tortolano
- EA Matériaux et Santé Université Paris‐Saclay Châtenay‐Malabry France
- Department of Pharmacy Assistance Publique‐Hôpitaux de Paris, Groupe Hospitalier Henri Mondor Créteil France
| | - Omar Mrad
- EA Matériaux et Santé Université Paris‐Saclay Châtenay‐Malabry France
| | - Katia Manerlax
- EA Matériaux et Santé Université Paris‐Saclay Châtenay‐Malabry France
| | - Chaineze Khalfoun
- EA Matériaux et Santé Université Paris‐Saclay Châtenay‐Malabry France
| | - Rayane Yousfi
- EA Matériaux et Santé Université Paris‐Saclay Châtenay‐Malabry France
| | - Johanna Saunier
- EA Matériaux et Santé Université Paris‐Saclay Châtenay‐Malabry France
| | | | - Najet Yagoubi
- EA Matériaux et Santé Université Paris‐Saclay Châtenay‐Malabry France
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5
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Role of fibronectin and IOL surface modification in IOL: Lens capsule interactions. Exp Eye Res 2022; 221:109135. [PMID: 35662618 DOI: 10.1016/j.exer.2022.109135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/20/2022]
Abstract
Posterior Capsule Opacification (PCO) is one of the most common complications of cataract surgery. While studies have shown that IOL material properties and fibronectin adsorption may affect IOL-induced PCO in the clinical setting, the mechanism governing such interactions is not totally understood. Since strong adhesion forces between IOLs and posterior capsules (PCs) have been shown to impede cell infiltration and thus reduce PCO formation, this study was designed to assess whether fibronectin adsorption and IOL material properties would impact the IOL:PC adhesion force and cell infiltration using a PCO predictive in vitro model and a macromolecular dye imaging model, respectively. Our results showed that fibronectin adsorption significantly increased the adhesion forces and reduced simulated cell infiltration between acrylic foldable IOLs and the PC at physiological temperature in comparison to fibronectin-free controls. This fibronectin-mediated strong IOL: PC bond may be contributing to low PCO rates in the clinic for acrylic foldable IOLs. In addition, acrylic foldable IOLs coated with Di(ethylene glycol) (Diglyme), a hydrophilic coating known to reduce protein adsorption, was tested for its ability to alter adhesion force and cell infiltration. We observed that IOLs coated with Diglyme coating greatly reduced surface hydrophobicity and fibronectin adsorption of acrylic foldable IOLs. Furthermore, Diglyme coated IOLs showed significantly reduced adhesion force and increased simulated cell infiltration at the IOL:PC interface. The overall results support the hypothesis that IOL surface properties and their ability to adsorb fibronectin may have great impact on the IOL:PC adhesion force. A tight binding between IOLs and PC may contribute to the reduction of cell infiltration and thus the PCO incidence rate in the clinic.
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Horn JD, Fisher BL, Terveen D, Fevrier H, Merchea M, Gu X. Academy IRIS® Registry Analysis of Incidence of Laser Capsulotomy Due to Posterior Capsule Opacification After Intraocular Lens Implantation. Clin Ophthalmol 2022; 16:1721-1730. [PMID: 35673348 PMCID: PMC9167596 DOI: 10.2147/opth.s358059] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Jeffrey D Horn
- Vision for Life, Nashville, TN, USA
- Correspondence: Jeffrey D Horn, Vision for Life, Nashville, TN, USA, Tel +1 615-588-2020, Email
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Taiyab A, West-Mays J. Lens Fibrosis: Understanding the Dynamics of Cell Adhesion Signaling in Lens Epithelial-Mesenchymal Transition. Front Cell Dev Biol 2022; 10:886053. [PMID: 35656546 PMCID: PMC9152183 DOI: 10.3389/fcell.2022.886053] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/11/2022] [Indexed: 12/13/2022] Open
Abstract
Injury to the ocular lens perturbs cell-cell and cell-capsule/basement membrane interactions leading to a myriad of interconnected signaling events. These events include cell-adhesion and growth factor-mediated signaling pathways that can ultimately result in the induction and progression of epithelial-mesenchymal transition (EMT) of lens epithelial cells and fibrosis. Since the lens is avascular, consisting of a single layer of epithelial cells on its anterior surface and encased in a matrix rich capsule, it is one of the most simple and desired systems to investigate injury-induced signaling pathways that contribute to EMT and fibrosis. In this review, we will discuss the role of key cell-adhesion and mechanotransduction related signaling pathways that regulate EMT and fibrosis in the lens.
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Srinivasan S. Correction of corneal astigmatism and stability of toric intraocular lenses. J Cataract Refract Surg 2021; 47:1385-1386. [PMID: 34675146 DOI: 10.1097/j.jcrs.0000000000000836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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9
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Yu M, Huang Y, Wang Y, Xiao S, Wu X, Wu W. Three-dimensional assessment of posterior capsule-intraocular lens interaction with and without primary posterior capsulorrhexis: an intraindividual randomized trial. Eye (Lond) 2021; 36:2130-2136. [PMID: 34689182 PMCID: PMC9581986 DOI: 10.1038/s41433-021-01815-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/20/2021] [Accepted: 10/04/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To assess the morphologic and clinical features of posterior capsule-intraocular lens (IOL) interaction following cataract surgery with and without primary posterior continuous curvilinear capsulorrhexis (PPCCC) at a three-dimensional (3-D) level using Scheimpflug imaging. METHODS This prospective intraindividual randomized comparative study comprised 56 patients (112 eyes) with age-related cataract who had bilateral cataract surgery and hydrophobic acrylic IOLs implantation. In randomized order, cataract surgery with PPCCC was performed in 1 eye (PPCCC group), and the posterior capsule was left intact in the fellow eye (NPCCC group). Scheimpflug imaging containing 25 images distributed in 360° was taken 1 day, 1 week, 1 month, and 3 months postoperatively. RESULTS 46 patients completed 3 months follow-up. Posterior capsule-IOL interaction can be morphologically classified into two types including complete adhesion and floppy shape in PPCCC group, and six types including full area wave, full area flat, concentric ring wave, concentric ring flat, sector, and complete adhesion in NPCCC group. The adhesion index (AI), defined as the proportion of complete adhesion of posterior capsule-IOL in 25 cross-section tomograms, was 0.45 ± 0.45, 0.79 ± 0.37, 0.92 ± 0.26 and 1.00 ± 0.00 in PPCCC group, while 0.05 ± 0.18, 0.41 ± 0.47, 0.87 ± 0.34, and 0.96 ± 0.21 in NPCCC group at 1 day, 1 week, 1 month and 3 months postoperatively, respectively (p = 0.001, 0.001, 0.338 and 0.151). CONCLUSIONS 3-D Scheimpflug imaging was favorable in observing of posterior capsule-IOL interaction. Faster posterior capsule adhesion to the IOL was found in PPCCC group than in NPCCC group.
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Affiliation(s)
- Mengting Yu
- Department of Ophthalmology, Provincial Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Yue Huang
- Department of Ophthalmology, Provincial Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Yingbin Wang
- Department of Ophthalmology, Provincial Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Suzhen Xiao
- Department of Ophthalmology, Provincial Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Xinna Wu
- Department of Ophthalmology, Provincial Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Wenjie Wu
- Department of Ophthalmology, Provincial Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, 350001, China.
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10
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Song Y, Overmass M, Fan J, Hodge C, Sutton G, Lovicu FJ, You J. Application of Collagen I and IV in Bioengineering Transparent Ocular Tissues. Front Surg 2021; 8:639500. [PMID: 34513910 PMCID: PMC8427501 DOI: 10.3389/fsurg.2021.639500] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/26/2021] [Indexed: 12/13/2022] Open
Abstract
Collagens represent a major group of structural proteins expressed in different tissues and display distinct and variable properties. Whilst collagens are non-transparent in the skin, they confer transparency in the cornea and crystalline lens of the eye. There are 28 types of collagen that all share a common triple helix structure yet differ in the composition of their α-chains leading to their different properties. The different organization of collagen fibers also contributes to the variable tissue morphology. The important ability of collagen to form different tissues has led to the exploration and application of collagen as a biomaterial. Collagen type I (Col-I) and collagen type IV (Col-IV) are the two primary collagens found in corneal and lens tissues. Both collagens provide structure and transparency, essential for a clear vision. This review explores the application of these two collagen types as novel biomaterials in bioengineering unique tissue that could be used to treat a variety of ocular diseases leading to blindness.
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Affiliation(s)
- Yihui Song
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Morgan Overmass
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jiawen Fan
- Key Laboratory of Myopia of State Health Ministry, Department of Ophthalmology and Vision Sciences, Eye and Ear, Nose, and Throat (ENT) Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Chris Hodge
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- New South Wales (NSW) Tissue Bank, Sydney, NSW, Australia
- Vision Eye Institute, Chatswood, NSW, Australia
| | - Gerard Sutton
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- New South Wales (NSW) Tissue Bank, Sydney, NSW, Australia
- Vision Eye Institute, Chatswood, NSW, Australia
| | - Frank J. Lovicu
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Discipline of Anatomy and Histology, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Jingjing You
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
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Jaitli A, Roy J, Chatila A, Liao J, Tang L. Effect of time and temperature-dependent changes of IOL material properties on IOL: Lens capsule interactions. Exp Eye Res 2021; 211:108726. [PMID: 34403680 DOI: 10.1016/j.exer.2021.108726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 11/15/2022]
Abstract
Posterior Capsule Opacification (PCO) is the most common complication associated with Intraocular Lens (IOL) implantation. Based on the assumption that the interactions between an IOL and the lens capsule (LC) may influence the extent of PCO formation, a new in vitro model was developed to quantify the adhesion force of an IOL to simulated LC using a custom-designed micro-force tester. Using this system, we examined the influence of temperature (room temperature vs. body temperature) and incubation time (0 vs. 24 h) on the adhesion force between IOLs and LCs. The results show that, in line with clinical observations of PCO incidence, the adhesion force increased at body temperature and with increase in incubation time in the following order, Acrylic foldable IOLs > Silicone IOLs > PMMA IOLs. By examining the changes of surface properties as a function of temperature and incubation time, we found that acrylic foldable IOLs showed the largest increase in their hydrophilicity and reported the lowest surface roughness in comparison to other IOL groups. Coincidentally, using a newly established macromolecular dye imaging system to simulate cell migration between IOLs and LC, we observed that the amount of macromolecular dye infiltration between IOLs and LCs was in the following order: PMMA IOLs > Silicone IOLs > Acrylic foldable IOLs. These results support a new potential mechanism that body temperature, incubation time, surface hydrophilicity and smoothness of IOLs greatly contribute to their tight binding to LCs and such tight binding may lead to reduced IOL: LC space, cell infiltration, and thus PCO formation.
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Affiliation(s)
- Arjun Jaitli
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Joyita Roy
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Amjad Chatila
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Jun Liao
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Liping Tang
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA; Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
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12
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Uveal and capsular biocompatibility of a new hydrophobic acrylic microincision intraocular lens. J Cataract Refract Surg 2021; 46:459-464. [PMID: 32079847 DOI: 10.1097/j.jcrs.0000000000000117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate uveal biocompatibility and capsular bag opacification of a new hydrophobic acrylic microincision intraocular lens (IOL) in comparison with a commercially available 1-piece hydrophobic acrylic IOL. SETTING John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. DESIGN Experimental study. METHODS Eight New Zealand rabbits underwent bilateral phacoemulsification and implantation of the preloaded Nanex multiSert IOL in one eye and a commercially available preloaded lens (AcrySof IQ in UltraSert, model AU00T0) in the contralateral eye. A slitlamp examination was performed weekly for 4 weeks. The rabbits were then killed humanely and their globes enucleated. Capsular bag opacification was assessed from the Miyake-Apple view, and the eyes were subjected to histopathologic evaluation. RESULTS Postoperative inflammatory reactions were similar between the test and control eyes in the 8 New Zealand rabbits. The mean postmortem central posterior capsule opacification (PCO) was 0.93 ± 0.73 in the test group and 1.19 ± 0.53 in the control group. The mean postmortem peripheral PCO was 1.75 ± 0.92 in the test group and 2.06 ± 0.77 in the control group. Central and peripheral PCO scores were not statistically different between the test and control groups (P = .41 and P = .35, respectively, 2-tailed t test: paired 2-sample for means). CONCLUSIONS A new 1-piece hydrophobic acrylic microincision IOL incorporating an ultraviolet-ozone treatment on the posterior surface performed similarly to a commercially available 1-piece hydrophobic acrylic IOL in terms of uveal and capsular biocompatibility in the rabbit model. To our knowledge, this is the first hydrophobic acrylic microincision IOL to demonstrate similar PCO performance when compared with a conventional, commercially available IOL.
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Wormstone IM, Damm NB, Kelp M, Eldred JA. Assessment of intraocular lens/capsular bag biomechanical interactions following cataract surgery in a human in vitro graded culture capsular bag model. Exp Eye Res 2021; 205:108487. [PMID: 33571531 DOI: 10.1016/j.exer.2021.108487] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/22/2021] [Accepted: 02/01/2021] [Indexed: 12/19/2022]
Abstract
Intraocular lenses (IOLs) are implanted during cataract surgery. For optimum results, stable positioning of the IOL in the capsular bag is important. Wound-healing events following cataract surgery lead to modification of the capsular bag and secondary visual loss due to posterior capsule opacification. At present, it is unclear how these biological events can affect stability of the IOL within the capsular bag. In the present study, a human in vitro graded culture capsular bag model was the experimental system. Capsulorhexis and lens extraction performed on human donor eyes generated suspended capsular bags (5 match-paired experiments). Preparations were secured by pinning the ciliary body to a silicone ring and maintained in 6 mL of medium for 84 days using a graded culture system: days 1-3, 5% human serum and 10 ng/mL transforming growth factor β (TGFβ2); days 4-7, 2% human serum and 1 ng/mL TGFβ2; days 8-14, 1% human serum and 0.1 ng/mL TGFβ2; days 15-84, serum-free Eagle's minimum essential medium (EMEM). A CT LUCIA 611PY IOL was implanted in all preparations. Quantitative measures were determined from whole bag images captured weekly. Images were registered using FIJI and analysed in ImageJ to determine capsular bag area; distortion; angle of contact; haptic stability; capsulorhexis area; and a fusion footprint associated with connection between the anterior and posterior capsules. Cell coverage and light scatter were quantified at end-point. The transdifferentiation marker, α-SMA was assessed by immunocytochemistry. Immediately following surgery, distortion of the capsular bag was evident, such that a long axis is generated between haptics relative to the non-haptic regions (short axis). The angle of contact between the haptics and the peripheral bag appeared inversely correlated to capsular bag area. Growth on the peripheral posterior capsule was observed 1 week after surgery and beneath the IOL within 1 month. As coverage of the posterior capsule progressed this was associated with matrix contraction/wrinkles of both the central posterior capsule and peripheral capsular bag. Cells on the central posterior capsule expressed αSMA. Fusion footprints formed in non-haptic regions of the peripheral bag and progressively increased over the culture period. Within and at the edge of the fusion footprint, refractive structures resembling lens fibre cells and Elschnig's pearls were observed. Cell attachment to the IOL was limited. An impression in the posterior capsule associated with the CT LUCIA 611PY optic edge was evident; cell density was much greater peripheral to this indent. Wound-healing events following surgery reduced capsular bag area. This was associated with the long/short axis ratio and angle of contact increasing with time. In summary, we have developed a human capsular bag model that exhibits features of fibrotic and regenerative PCO. The model permits biomechanical information to be obtained that enables better understanding of IOL characteristics in a clinically relevant biological system. Throughout culture the CT LUCIA 611PY appeared stable in its position and capsular bag modifications did not change this. We propose that the CT LUCIA 611PY optic edge shows an enhanced barrier function, which is likely to provide better PCO management in patients.
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Affiliation(s)
- I Michael Wormstone
- School of Biological Sciences, University of East Anglia, Norwich, NR4 7TJ, UK.
| | - Niklas B Damm
- ZEISS Ophthalmic Devices, Carl Zeiss Meditec AG, 10589, Berlin, Germany
| | - Martin Kelp
- ZEISS Ophthalmic Devices, Carl Zeiss Meditec AG, 10589, Berlin, Germany
| | - Julie A Eldred
- School of Biological Sciences, University of East Anglia, Norwich, NR4 7TJ, UK
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14
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Chen X, Yan H, Chen Y, Li G, Bin Y, Zhou X. Moderate oxidative stress promotes epithelial-mesenchymal transition in the lens epithelial cells via the TGF-β/Smad and Wnt/β-catenin pathways. Mol Cell Biochem 2021; 476:1631-1642. [PMID: 33417163 DOI: 10.1007/s11010-020-04034-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/22/2020] [Indexed: 12/20/2022]
Abstract
The epithelial-mesenchymal transition (EMT) plays a significant role in fibrosis and migration of lens epithelial cells (LECs), and eventually induces posterior capsule opacification (PCO). In the past, it was generally believed that the TGF-β/Smad pathway regulates lens EMT. A recent study found that attenuated glutathione level promotes LECs EMT via the Wnt/β-catenin pathway, which suggests a more complex pathogenesis of PCO. To test the hypothesis, we used the mouse cataract surgery PCO model and tested both canonical Wnt/β-catenin and TGF-β/Smad signaling pathways. The results showed that both TGF-β/Smad and Wnt/β-catenin pathways were activated during the lens capsule fibrosis. Compared with the freshly isolated posterior capsule, the expression level of phosphorylated Smad2 was highest at day3 and then slightly decreased, but the expression level of Wnt10a gradually increased from day0 to day7. It shows that these two pathways are involved in the lens epithelium's fibrotic process and may play different roles in different periods. Subsequently, we established oxidative stress-induced EMT model in primary porcine lens epithelial cells and found that both the TGF-β/Smad and Wnt/β-catenin pathways were activated. Further study suggests that block Wnt/β-catenin pathway using XAV939 alone or block TGF-β/Smad pathway using LY2109761 could partially block pLECs fibrosis, but blocking Wnt/β-catenin and TGF-β/Smad pathway using combined XAV939 and LY2109761 could completely block pLECs fibrosis. In conclusion, this study demonstrates that both TGF-β/Smad and canonical Wnt/β-catenin pathways play a significant role in regulating epithelial-mesenchymal transformation of lens epithelial cells but might be in a different stage.
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Affiliation(s)
- Xi Chen
- Department of Ophthalmology, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Hong Yan
- Shaanxi Eye Hospital, Affiliated Xi'an Fourth Hospital, Northwestern Polytechnical University, Xi'an, 710004, Shaanxi Province, China
| | - Ying Chen
- Shaanxi Eye Hospital, Affiliated Xi'an Fourth Hospital, Northwestern Polytechnical University, Xi'an, 710004, Shaanxi Province, China
| | - Guo Li
- Department of Ophthalmology, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Yue Bin
- Department of Ophthalmology, First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xiyuan Zhou
- Department of Ophthalmology, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
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15
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Jaitli A, Roy J, Mcmahan S, Liao J, Tang L. An in vitro system to investigate IOL: Lens capsule interaction. Exp Eye Res 2021; 203:108430. [PMID: 33422509 DOI: 10.1016/j.exer.2020.108430] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 02/03/2023]
Abstract
Posterior capsule opacification (PCO) is the most common complication associated with intraocular lens (IOL) implantation. Unfortunately, current in vitro models cannot be used to assess the potential of PCO due to their failure to simulate the posterior curvature of the lens capsule (LC) and IOL, a factor known to affect PCO pathogenesis in clinic. To overcome such a challenge, a new system to study IOL: LC interaction and potentially predict PCO was developed in this effort. It is believed that the interactions between an IOL and the lens capsule may influence the extent of PCO formation. Specifically, strong adhesion force between an IOL and the LC may impede lens epithelial cell migration and proliferation and thus reduce PCO formation. To assess the adhesion force between an IOL and LC, a new in vitro model was established with simulated LC and a custom-designed micro-force tester. A method to fabricate simulated LCs was developed by imprinting IOLs onto molten gelatin to create simulated three dimensional (3D) LCs with curvature resembling the bag-like structure that collapses on the IOL post implantation. By pushing the LC mold vertically downward, while measuring the change in position of the bending bar with respect to its start position, the adhesion force between the IOLs and LCs was measured. An in vitro system that can measure the adhesion force reproducibly between an IOL and LC with a resolution of ~1 μN was established in this study. During system optimization, the 10% high molecular weight gelatin produced the best LC with the highest IOL: LC adhesion force with all test lenses that were fabricated from acrylic foldable, polymethylmethacrylate (PMMA) and silicone materials. Test IOLs exerted different adhesion force with the 3D simulated LCs in the following sequence: acrylic foldable IOL > silicone IOL > PMMA IOL. These results are in good agreement with the clinical observations associated with PCO performance of IOLs made of the same materials. This novel in vitro system can provide valuable insight on the IOL: LC interplay and its relationship to clinical PCO outcomes.
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Affiliation(s)
- Arjun Jaitli
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Joyita Roy
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Sara Mcmahan
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Jun Liao
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA
| | - Liping Tang
- Department of Bioengineering, University of Texas at Arlington, Arlington, TX, 76019, USA.
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Wormstone IM, Wormstone YM, Smith AJO, Eldred JA. Posterior capsule opacification: What's in the bag? Prog Retin Eye Res 2020; 82:100905. [PMID: 32977000 DOI: 10.1016/j.preteyeres.2020.100905] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 12/18/2022]
Abstract
Cataract, a clouding of the lens, is the most common cause of blindness in the world. It has a marked impact on the wellbeing and productivity of individuals and has a major economic impact on healthcare providers. The only means of treating cataract is by surgical intervention. A modern cataract operation generates a capsular bag, which comprises a proportion of the anterior capsule and the entire posterior capsule. The bag remains in situ, partitions the aqueous and vitreous humours, and in the majority of cases, houses an intraocular lens (IOL). The production of a capsular bag following surgery permits a free passage of light along the visual axis through the transparent intraocular lens and thin acellular posterior capsule. Lens epithelial cells, however, remain attached to the anterior capsule, and in response to surgical trauma initiate a wound-healing response that ultimately leads to light scatter and a reduction in visual quality known as posterior capsule opacification (PCO). There are two commonly-described forms of PCO: fibrotic and regenerative. Fibrotic PCO follows classically defined fibrotic processes, namely hyperproliferation, matrix contraction, matrix deposition and epithelial cell trans-differentiation to a myofibroblast phenotype. Regenerative PCO is defined by lens fibre cell differentiation events that give rise to Soemmerring's ring and Elschnig's pearls and becomes evident at a later stage than the fibrotic form. Both fibrotic and regenerative forms of PCO contribute to a reduction in visual quality in patients. This review will highlight the wealth of tools available for PCO research, provide insight into our current knowledge of PCO and discuss putative management of PCO from IOL design to pharmacological interventions.
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Affiliation(s)
- I M Wormstone
- School of Biological Sciences, University of East Anglia, Norwich, UK.
| | - Y M Wormstone
- School of Biological Sciences, University of East Anglia, Norwich, UK
| | - A J O Smith
- School of Biological Sciences, University of East Anglia, Norwich, UK
| | - J A Eldred
- School of Biological Sciences, University of East Anglia, Norwich, UK
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17
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Werner L. Intraocular Lenses: Overview of Designs, Materials, and Pathophysiologic Features. Ophthalmology 2020; 128:e74-e93. [PMID: 32619547 DOI: 10.1016/j.ophtha.2020.06.055] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/17/2020] [Accepted: 06/24/2020] [Indexed: 11/29/2022] Open
Abstract
This article provides an overview of intraocular lenses (IOLs) currently used in cataract surgery. Aspects presented include design features related to IOL construction and sites of fixation; optic, filter, and haptic materials; as well as pathophysiologic features of uveal biocompatibility, capsular biocompatibility, and postoperative IOL opacification. This overview also includes supplementary (add-on; piggyback) lenses implanted in eyes that are already pseudophakic and considerations on IOLs used in the pediatric population. Different IOLs are made available to surgeons each year, including lenses with increasingly complex design characteristics owing to advancements in manufacturing and surgical techniques.
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Affiliation(s)
- Liliana Werner
- Intermountain Ocular Research Center, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah.
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18
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VanSlyke JK, Boswell BA, Musil LS. Fibronectin regulates growth factor signaling and cell differentiation in primary lens cells. J Cell Sci 2018; 131:jcs.217240. [PMID: 30404825 DOI: 10.1242/jcs.217240] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 09/23/2018] [Indexed: 12/30/2022] Open
Abstract
Lens epithelial cells are bound to the lens extracellular matrix capsule, of which laminin is a major component. After cataract surgery, surviving lens epithelial cells are exposed to increased levels of fibronectin, and so we addressed whether fibronectin influences lens cell fate, using DCDML cells as a serum-free primary lens epithelial cell culture system. We found that culturing DCDMLs with plasma-derived fibronectin upregulated canonical TGFβ signaling relative to cells plated on laminin. Fibronectin-exposed cultures also showed increased TGFβ signaling-dependent differentiation into the two cell types responsible for posterior capsule opacification after cataract surgery, namely myofibroblasts and lens fiber cells. Increased TGFβ activity could be identified in the conditioned medium recovered from cells grown on fibronectin. Other experiments showed that plating DCDMLs on fibronectin overcomes the need for BMP in fibroblast growth factor (FGF)-induced lens fiber cell differentiation, a requirement that is restored when endogenous TGFβ signaling is inhibited. These results demonstrate how the TGFβ-fibronectin axis can profoundly affect lens cell fate. This axis represents a novel target for prevention of late-onset posterior capsule opacification, a common but currently intractable complication of cataract surgery.
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Affiliation(s)
- Judy K VanSlyke
- Department of Biochemistry and Molecular Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Bruce A Boswell
- Department of Biochemistry and Molecular Biology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Linda S Musil
- Department of Biochemistry and Molecular Biology, Oregon Health & Science University, Portland, OR 97239, USA
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In vivo evaluation of a new hydrophobic acrylic intraocular lens in the rabbit model. J Cataract Refract Surg 2018; 44:1497-1502. [PMID: 30228013 DOI: 10.1016/j.jcrs.2018.07.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 06/25/2018] [Accepted: 07/04/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate the uveal and capsular biocompatibility as well as positioning stability of a new hydrophobic acrylic intraocular lens (IOL) in vivo in the rabbit model and compare it with a commercially available IOL. SETTING John A Moran Eye Center, University of Utah, Salt Lake City, Utah, USA. DESIGN Experimental study. METHODS Fifteen New Zealand rabbits had the new test IOL (Clareon CNA0T0) implanted in one eye and a control IOL (Acrysof SN60WF) implanted in the contralateral eye. The test IOL is manufactured from a new hydrophobic acrylic material incorporating ultraviolet blocker and blue light filter. Its design is based on the control IOL's platform. The rabbits were followed up with weekly slitlamp evaluations, which assessed inflammatory reactions as well as capsular bag opacification. Anterior chamber depth was measured at 1 and 4 weeks post-implantation (high-frequency ultrasound). After 4 weeks, the rabbits were killed humanely and the eyes were enucleated. The anterior segment was evaluated from the posterior or Miyake-Apple view, and was then processed for complete histopathology. RESULTS There were no statistically significant differences between test and control eyes in terms of postoperative inflammation and capsular biocompatibility, including posterior capsule opacification (P = .34, paired t test), and anterior capsule opacification (P = .53, paired t test), as observed during clinical and pathological evaluation. In vivo axial positioning for the test IOL was comparable to the control IOL and stable over time (P = .531 versus P = .788). CONCLUSIONS The new IOL showed biocompatibility and stability comparable to the control IOL.
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20
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Vandekerckhove K. Rotational Stability of Monofocal and Trifocal Intraocular Toric Lenses With Identical Design and Material but Different Surface Treatment. J Refract Surg 2018; 34:84-91. [PMID: 29425386 DOI: 10.3928/1081597x-20171211-01] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 11/20/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare the rotational stability, total misalignment, and visual and refractive outcomes achieved with a trifocal toric versus a monofocal toric intraocular lens (IOL). METHODS In this prospective, interventional case series, eyes of patients consecutively scheduled for cataract surgery who had clinically relevant astigmatism were implanted with a FineVision Pod FT trifocal toric IOL or an Ankoris monofocal toric IOL (both PhysIOL SA, Liège, Belgium). Certain comorbidities, such as pseudoexfoliation syndrome, were allowed. IOL rotation and total misalignment were analyzed 15 minutes, 1 day, 1 week, 6 weeks, 6 months, and 1 year postoperatively. RESULTS Seventy-one eyes of 53 patients were assessed: 37 eyes were implanted with the trifocal IOL and 34 eyes with the monofocal IOL. More IOL rotation occurred in the monofocal group compared to the trifocal group (mean 4.23° ± 4.64° vs 2.55° ± 2.62°; P = .043, 12 months). Mean total misalignment was higher in the monofocal group (6.67° ± 6.59° at 12 months vs 3.79° ± 3.59° in the trifocal group) (P = .017). Postoperatively, more eyes achieved a refractive cylinder of 0.50 diopters or below in the trifocal group (65% at 12 months) than in the monofocal group, even in the monofocal subgroup analysis that excluded keratoconic eyes (42% at 12 months; P = .009). CONCLUSIONS The monofocal and trifocal toric IOLs both appear to effectively reduce refractive astigmatism and provide good visual acuity in astigmatic patients having cataract surgery. The trifocal toric IOL offers better rotational stability than the monofocal IOL, probably due to the higher frictional coefficient of its surface. [J Refract Surg. 2018;34(2):84-91.].
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21
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Biomaterial Influence on Intraocular Lens Performance: An Overview. J Ophthalmol 2018; 2018:2687385. [PMID: 29736282 PMCID: PMC5874989 DOI: 10.1155/2018/2687385] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 12/08/2017] [Accepted: 01/02/2018] [Indexed: 11/18/2022] Open
Abstract
There is strong evidence that the IOL material is the factor having the greatest impact on posterior capsule opacification (PCO), anterior capsule opacification (ACO) development, and glistening formation after cataract surgery, even though there are other IOL features—such as haptic material and design and edge and optic design—that also have some influence. We reviewed the published literature describing the adverse events that are mainly related to the intraocular lens (IOL) material, such as PCO, ACO, and the subsequent capsule contraction, as well as glistening formation. The adverse events presented in this overview are the most common ones in clinical practice, and therefore, they are generally included in the clinical protocols for IOL evaluation.
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22
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Scanning Electron Microscopy and Energy Dispersive Spectroscopy Findings in Explanted Pmma and Hydrophilic Acrylic Intraocular Lenses. Eur J Ophthalmol 2018; 19:28-36. [DOI: 10.1177/112067210901900105] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose To investigate the presence of calcium (Ca) aggregates influencing biocompatibility and the factors that affect calcium accumulation in explanted intraocular lenses (IOL) and to analyze the Ca distribution in an opacified hydrophilic acrylic lens. Methods Surface irregularities and aggregates of 13 IOLs were studied with scanning electron microscopy, and their relative concentrations with energy dispersive spectroscopy (EDS). Relationships of distribution between Ca and silicone (Si) and nitrogen (N) and between N and Si and Na, and the influence of Si on Ca accumulation and the effect of differences in lens material on the distribution of N, and the effect of endophthalmitis on the distribution of Ca were evaluated statistically. EDS analyses were performed on the surface and cross-section of the opacified lens. Results The statistically significant relationships between the distribution of Ca and N, and between the distribution of N and Na, the significant effect of Si on the Ca accumulation, significant relationship between endophthalmitis and the Ca accumulation in the aggregates were shown. The EDS analysis of the opacified IOL, Ca and P peaks were shown from the whole surface, Ca, O peaks were determined from cross-sections over a 70–80 μm distance. Conclusions In the aggregates influencing IOL biocompatibility, presence of proteins was determined to be more important than the presence of Si regarding the distribution of Ca, while the presence of Si affected the accumulation of Ca. Opacification, caused by the Ca accumulation within the lens, was found to result from Ca penetrating from lens pores.
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23
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Wei Z, Caty J, Whitson J, Zhang AD, Srinivasagan R, Kavanagh TJ, Yan H, Fan X. Reduced Glutathione Level Promotes Epithelial-Mesenchymal Transition in Lens Epithelial Cells via a Wnt/β-Catenin-Mediated Pathway: Relevance for Cataract Therapy. THE AMERICAN JOURNAL OF PATHOLOGY 2017; 187:2399-2412. [PMID: 28827139 DOI: 10.1016/j.ajpath.2017.07.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/19/2017] [Accepted: 07/26/2017] [Indexed: 12/11/2022]
Abstract
The epithelial-mesenchymal transition (EMT) process plays a pivotal role in the pathogenesis of posterior capsular opacification because of remnant lens epithelial cell proliferation, migration, and transformation after cataract surgery. The latter, we hypothesize, may result in posterior capsule wrinkling and opacification because of a profound change in the lens growth environment via a 1000-fold reduction of extracellular glutathione (GSH) levels. To test this hypothesis, we investigated the EMT process in cell culture and GSH biosynthesis deficiency mouse models. Our data indicate a dramatic increase of pro-EMT markers, such as type I collagen, α-smooth muscle actin, vimentin, and fibronectin, under conditions of lens GSH depletion. Further study suggests that decreased GSH triggers the Wnt/β-catenin signal transduction pathway, independent of transforming growth factor-β. Equally important, the antioxidants N-acetyl cysteine and GSH ethyl ester could significantly attenuate the EMT signaling stimulated by decreased GSH levels. These findings were further confirmed by mock cataract surgery in both gamma glutamyl-cysteine ligase, catalytic subunit, and gamma glutamyl-cysteine ligase, modifier subunit, knockout mouse models. Remarkably, increased EMT marker expression, β-catenin activation, and translocation into the nucleus were found in both knockout mice compared with the wild type, and such increased expression could be significantly attenuated by N-acetyl cysteine or GSH ethyl ester treatment. This study, for the first time we believe, links oxidative stress to lens fibrosis and posterior capsular opacification formation via EMT-mediated mechanisms.
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Affiliation(s)
- Zongbo Wei
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio
| | - Jane Caty
- Department of Ophthalmology, University Hospitals of Cleveland Medical Center, Cleveland, Ohio
| | - Jeremy Whitson
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio
| | - Amy D Zhang
- Department of Ophthalmology, University Hospitals of Cleveland Medical Center, Cleveland, Ohio
| | | | - Terrance J Kavanagh
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington
| | - Hong Yan
- Department of Ophthalmology, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China; Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xingjun Fan
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio.
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24
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Joshi RS. Postoperative posterior capsular striae and the posterior capsular opacification in patients implanted with two types of intraocular lens material. Indian J Ophthalmol 2017; 65:466-471. [PMID: 28643710 PMCID: PMC5508456 DOI: 10.4103/ijo.ijo_344_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 05/17/2017] [Indexed: 11/15/2022] Open
Abstract
AIM To evaluate the incidence of postoperative posterior capsular striae (PCS) and its influence on posterior capsular opacification (PCO) in patients implanted with two types of lens material. SETTING Tertiary eye care center in central rural India. STUDY DESIGN A prospective, observational, nonrandomized study. MATERIALS AND METHODS The study included 1247 patients having age-related cataract scheduled for removal by phacoemulsification technique and implantation of hydrophilic or hydrophobic intraocular lens (IOL). Demographic profile, nuclear grading, axial length, and IOL power were noted. Details of PCS were noted on the 1st postoperative day in patients with clear cornea. Postoperative follow-up was ensured to study the status of PCS and development of PCO. RESULTS The overall incidence of PCS was 19.8% (247 out of 1247 eyes). Out of 1247 patients, 641 patients (51.4%) had hydrophilic IOL implantation and 201 eyes had PCS (31.4%) and 606 patients (48.6%) had hydrophobic IOL implantation and 46 eyes had PCS (7.6%), P = 0.04. Three and more striae were seen in 119 eyes (119/641, 18.6%) in hydrophilic group and 4 eyes (4/606, 0.66%) in hydrophobic group. Sixty-two eyes (62/201, 30.9%) in hydrophilic group with multiple PCS were reported with persistent striae after 6 months of surgery. Two eyes in hydrophobic group had persistent striae even after 3 years of follow-up. Evaluation of PCO score of the hydrophilic group was 0.6 whereas of the hydrophobic group was 0.1 (P = 0.04). Ten patients of the hydrophilic group only required neodymium-doped yttrium aluminum garnet (ND: YAG) laser capsulotomy. CONCLUSION The incidence of PCS was higher in hydrophilic than hydrophobic IOLs. Multiple PCS persisting in patients beyond 6 months after operation should be followed up for early development of PCO, particularly in patients implanted with hydrophilic IOL.
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Affiliation(s)
- Rajesh Subhash Joshi
- Department of Ophthalmology, Shri Vasantrao Government Medical College, Yavatmal, Maharashtra, India
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25
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Hayashi R, Hayashi S, Arai K, Yoshida S, Chikuda M, Machida S. Evaluating the Biostability of Yellow and Clear Intraocular Lenses with a System Simulating Natural Intraocular Environment. Transl Vis Sci Technol 2016; 5:11. [PMID: 27933221 PMCID: PMC5142717 DOI: 10.1167/tvst.5.6.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 09/27/2016] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Blue light-filtering intraocular lenses (IOLs) are thought to protect the retina from blue light damage after cataract surgery, and the implantation of yellow-tinted IOLs has been commonly used in cataract surgery. To our knowledge, this is the first investigation measuring the long-term biostability of yellow-tinted IOLs using an in vitro system simulating natural intraocular environment. METHODS Six hydrophobic acrylic IOLs, three clear IOLs, and three yellow-tinted IOLs were included in the study. Each yellow-tinted IOL was a matching counterpart of a clear IOL, with the only difference being the lens color. The IOLs were kept in conditions replicating the intraocular environment using a perfusion culture system for 7 months. Resolution, light transmittance rate, and the modulation transfer function (MTF) were measured before and after culturing. Surface roughness of the anterior and posterior surfaces was also measured. RESULTS After culturing for 7 months, there were no changes in the resolution, the light transmittance rate, and MTF. The surface roughness of the anterior and posterior surfaces increased after culturing; however, this increase was clinically insignificant. There were no differences in surface roughness between the clear and yellow-tinted IOLs, either before or after culturing. CONCLUSIONS A novel in vitro system replicating intraocular environment was used to investigate the biostability of yellow-tinted IOLs. The surface roughness showed no clinically significant increase after culturing for 7 months. TRANSLATIONAL RELEVANCE This system is useful for evaluating the biostability of IOLs.
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Affiliation(s)
- Rijo Hayashi
- Department of Ophthalmology, Koshigaya Hospital, Dokkyo Medical University, Koshigaya, Saitama, Japan
| | - Shimmin Hayashi
- Department of Ophthalmology, Koshigaya Hospital, Dokkyo Medical University, Koshigaya, Saitama, Japan ; Lively Eye Clinic, Soka, Saitama, Japan
| | - Kiyomi Arai
- Department of Ophthalmology, Koshigaya Hospital, Dokkyo Medical University, Koshigaya, Saitama, Japan
| | - Shinichirou Yoshida
- Department of Ophthalmology, Koshigaya Hospital, Dokkyo Medical University, Koshigaya, Saitama, Japan ; Yoshida Eye Hospital, Hokodate, Hokkaido, Japan
| | - Makoto Chikuda
- Department of Ophthalmology, Koshigaya Hospital, Dokkyo Medical University, Koshigaya, Saitama, Japan
| | - Shigeki Machida
- Department of Ophthalmology, Koshigaya Hospital, Dokkyo Medical University, Koshigaya, Saitama, Japan
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Posterior Capsule Opacification 9 Years after Phacoemulsification with a Hydrophobic and a Hydrophilic Intraocular Lens. Eur J Ophthalmol 2016; 27:164-168. [DOI: 10.5301/ejo.5000831] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2016] [Indexed: 11/20/2022]
Abstract
Purpose To compare the development of posterior capsule opacification (PCO) and survival rate without capsulotomy after implantation of a hydrophobic or hydrophilic acrylic intraocular lens (IOL) at the 9-year postoperative follow-up. Methods One of 3 experienced cataract surgeons performed standard phacoemulsification in one eye of 120 patients with cataract. The patients were randomized to implantation of either a hydrophobic acrylic IOL or a hydrophilic acrylic IOL. Both IOLs had sharp posterior edges. Retroillumination images of PCO were obtained with a fundus camera 9 years postoperatively and analyzed semiobjectively using POCOman computer software. Results Seventy-eight of the 120 patients completed the 9-year follow-up examination. Patients implanted with the hydrophilic IOL had significantly (p<0.001) more and denser PCO. The survival rate without Nd:YAG capsulotomy was significantly higher (p<0.001) in eyes with the hydrophobic IOL. Conclusions After 9 years, more and denser PCO developed in eyes with the hydrophilic IOL than the hydrophobic IOL. The survival rate without the need for capsulotomy was higher in eyes with the hydrophobic IOL.
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Wang GQ, Dang YL, Huang Q, Woo VCP, So KF, Lai JSM, Cheng GPM, Chiu K. In Vitro Evaluation of the Effects of Intraocular Lens Material on Lens Epithelial Cell Proliferation, Migration, and Transformation. Curr Eye Res 2016; 42:72-78. [DOI: 10.3109/02713683.2016.1156133] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Abstract
PURPOSE OF REVIEW This article reviews current concepts in intraocular lens alignment strategies to maximize intraocular lens (IOL) positioning. RECENT FINDINGS A variety of strategies has been developed to maximize toric IOL position, including preoperative calculators to determine the appropriate IOL power and orientation, intraoperative alignment devices, and postoperative software to determine if IOL rotation would be beneficial for refractive outcomes. SUMMARY The combination of using multiple toric IOL calculators and intraoperative alignment devices has improved toric IOL outcomes. The relationship of the posterior corneal power and its effect on outcomes remains to be fully elucidated. Postoperative IOL rotation may be necessary even when the IOL is aligned as planned because of surgically induced astigmatism.
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Bhattacharjee H, Bhattacharjee K, Bhattacharjee P, Das D, Gogoi K, Arati D. Liquefied after cataract and its surgical treatment. Indian J Ophthalmol 2015; 62:580-4. [PMID: 24881605 PMCID: PMC4065509 DOI: 10.4103/0301-4738.129771] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aims: To describe liquefied after cataract (LAC) and its surgical management following an uneventful phacoemulsification with posterior chamber in-the-bag intraocular lens (IOL) implantation and continuous curvilinear capsulorrhexis (CCC). Design: Interventional case series. Materials and Methods: Eleven patients with LAC, following uneventful phacoemulsification with CCC and in-the-bag IOL implantation were enrolled. After the basic slit lamp examination, each case was investigated with Scheimpflug photography and ultrasound biomicroscopy (UBM). Each case was treated with capsular lavage. Biochemical composition of the milky fluid was evaluated and ring of anterior capsular opacity (ACO) was examined under electron microscope. Results: All 11 cases presented with blurring of vision after 6-8 years of cataract surgery with IOL implantation. All cases had IOL microvacuoles, 360° anterior capsule, and anterior IOL surface touch along with ACO, ring of Soemmering, and posterior capsule distension filled with opalescent milky fluid with whitish floppy or crystalline deposits. Biochemically, the milky fluid contained protein (800 mg/dl), albumin (100 mg/dl), sugar (105 mg/dl), and calcium (0.13%) and was bacteriologically sterile. Histologically, the dissected ACO showed fibrous tissue. All cases were successfully treated with capsular lavage with good visual recovery and with no complication. There was no recurrence of LAC during 2 years postoperative follow-up in any of the cases. Conclusions: LAC is a late complication of standard cataract surgery. It may be a spectrum of capsular bag distension syndrome (CBDS) without shallow anterior chamber and secondary glaucoma. Capsular bag lavage is a simple and effective treatment for LAC and a safe alternative to neodymium-doped yttrium aluminum garnet (Nd-YAG) capsulotomy.
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Affiliation(s)
- Harsha Bhattacharjee
- Department of Cataract and Refractive Surgery, Sri Sankaradeva Nethralya, Beltola, Guwahati, Assam, India
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Evaluation of uveal and capsule biocompatibility of a single-piece hydrophobic acrylic intraocular lens with ultraviolet–ozone treatment on the posterior surface. J Cataract Refract Surg 2015; 41:1081-7. [DOI: 10.1016/j.jcrs.2014.11.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/29/2014] [Accepted: 11/03/2014] [Indexed: 11/17/2022]
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Prevention of posterior capsular opacification. Exp Eye Res 2015; 136:100-15. [PMID: 25783492 DOI: 10.1016/j.exer.2015.03.011] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 02/04/2015] [Accepted: 03/13/2015] [Indexed: 01/22/2023]
Abstract
Posterior capsular opacification (PCO) is a common complication of cataract surgery. The development of PCO is due to a combination of the processes of proliferation, migration, and transdifferentiation of residual lens epithelial cells (LECs) on the lens capsule. In the past decades, various forms of PCO prevention have been examined, including adjustments of techniques and intraocular lens materials, pharmacological treatments, and prevention by interfering with biological processes in LECs. The only method so far that seems effective is the implantation of an intraocular lens with sharp edged optics to mechanically prevent PCO formation. In this review, current knowledge of the prevention of PCO will be described. We illustrate the biological pathways underlying PCO formation and the various approaches to interfere with the biological processes to prevent PCO. In this type of prevention, the use of nanotechnological advances can play a role.
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Tetz M, Jorgensen MR. New Hydrophobic IOL Materials and Understanding the Science of Glistenings. Curr Eye Res 2015; 40:969-81. [DOI: 10.3109/02713683.2014.978476] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Huang YS, Bertrand V, Bozukova D, Pagnoulle C, Labrugère C, De Pauw E, De Pauw-Gillet MC, Durrieu MC. RGD surface functionalization of the hydrophilic acrylic intraocular lens material to control posterior capsular opacification. PLoS One 2014; 9:e114973. [PMID: 25501012 PMCID: PMC4263720 DOI: 10.1371/journal.pone.0114973] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 11/17/2014] [Indexed: 11/19/2022] Open
Abstract
Posterior Capsular Opacification (PCO) is the capsule fibrosis developed on implanted IntraOcular Lens (IOL) by the de-differentiation of Lens Epithelial Cells (LECs) undergoing Epithelial Mesenchymal Transition (EMT). Literature has shown that the incidence of PCO is multifactorial including the patient's age or disease, surgical technique, and IOL design and material. Reports comparing hydrophilic and hydrophobic acrylic IOLs have shown that the former has more severe PCO. On the other hand, we have previously demonstrated that the adhesion of LECs is favored on hydrophobic compared to hydrophilic materials. By combining these two facts and contemporary knowledge in PCO development via the EMT pathway, we propose a biomimetically inspired strategy to promote LEC adhesion without de-differentiation to reduce the risk of PCO development. By surface grafting of a cell adhesion molecule (RGD peptide) onto the conventional hydrophilic acrylic IOL material, the surface-functionalized IOL can be used to reconstitute a capsule-LEC-IOL sandwich structure, which has been considered to prevent PCO formation in literature. Our results show that the innovative biomaterial improves LEC adhesion, while also exhibiting similar optical (light transmittance, optical bench) and mechanical (haptic compression force, IOL injection force) properties compared to the starting material. In addition, compared to the hydrophobic IOL material, our bioactive biomaterial exhibits similar abilities in LEC adhesion, morphology maintenance, and EMT biomarker expression, which is the crucial pathway to induce PCO. The in vitro assays suggest that this biomaterial has the potential to reduce the risk factor of PCO development.
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Affiliation(s)
- Yi-Shiang Huang
- Departments of Chemistry & Bio-Medical and Preclinical Sciences, Mass Spectrometry Laboratory & Mammalian Cell Culture Laboratory – GIGA R, Université de Liège, Liège, Belgium
- CBMN UMR5248, Institute of Chemistry & Biology of Membranes & Nanoobjects, Université de Bordeaux, Pessac, France
| | - Virginie Bertrand
- Departments of Chemistry & Bio-Medical and Preclinical Sciences, Mass Spectrometry Laboratory & Mammalian Cell Culture Laboratory – GIGA R, Université de Liège, Liège, Belgium
| | | | | | - Christine Labrugère
- PLACAMAT, Plateforme Aquitaine de Caractérisation des Matériaux, UMS 3626, Université de Bordeaux, Pessac, France
| | - Edwin De Pauw
- Departments of Chemistry & Bio-Medical and Preclinical Sciences, Mass Spectrometry Laboratory & Mammalian Cell Culture Laboratory – GIGA R, Université de Liège, Liège, Belgium
| | - Marie-Claire De Pauw-Gillet
- Departments of Chemistry & Bio-Medical and Preclinical Sciences, Mass Spectrometry Laboratory & Mammalian Cell Culture Laboratory – GIGA R, Université de Liège, Liège, Belgium
| | - Marie-Christine Durrieu
- CBMN UMR5248, Institute of Chemistry & Biology of Membranes & Nanoobjects, Université de Bordeaux, Pessac, France
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Posterior capsule opacification and neodymium:YAG rates with 2 single-piece hydrophobic acrylic intraocular lenses: three-year results. J Cataract Refract Surg 2014; 39:1886-92. [PMID: 24427796 DOI: 10.1016/j.jcrs.2013.06.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To compare the incidence and intensity of posterior capsule opacification (PCO) between 2 similar 1-piece foldable hydrophobic acrylic intraocular lenses (IOLs) over 3 years. SETTING Department of Ophthalmology, Medical University Vienna, Vienna, Austria. DESIGN Randomized prospective patient- and examiner-masked clinical trial with intraindividual comparison. METHODS Patients with bilateral age-related cataract had cataract surgery and implantation of a Tecnis ZCB00 continuous-optic-edge IOL in 1 eye and an Acrysof SA60AT interrupted-optic-edge IOL in the other eye. Postoperative examinations were performed at 6 months and 3 years. Digital retroillumination images were taken of each eye. The amount of PCO (score 0 to 10) was assessed subjectively at the slitlamp and objectively using automated image-analysis software. RESULTS The study comprised 54 patients (108 eyes). The mean objective PCO score was 1.3 ± 1.7 (SD) for the continuous-optic-edge IOLs and 0.9 ± 1.3 for the interrupted-optic-edge IOLs (P=.10). Three years postoperatively, a neodymium:YAG (Nd:YAG) capsulotomy was performed in 26.1% of eyes with the continuous-optic-edge IOL and 21.7% with the interrupted-optic-edge IOL (P=.56). There was no significant difference in corrected distance visual acuity, capsulorhexis–IOL overlap, capsule folds, or anterior capsule opacification 3 years after surgery. CONCLUSIONS Both IOLs had comparable PCO and Nd:YAG rates 3 years postoperatively. The optimized barrier function of the continuous-optic-edge IOL and the material properties of the interrupted-optic-edge IOL seemingly outbalanced the effect on lens epithelial cell migration and proliferation beneath the optic.
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A prospective evaluation of posterior capsule opacification in eyes with diabetes mellitus: a case-control study. Eye (Lond) 2014; 28:720-7. [PMID: 24675577 DOI: 10.1038/eye.2014.60] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 02/03/2014] [Indexed: 12/23/2022] Open
Abstract
AIM To compare the development of posterior capsule opacification (PCO) between eyes with and without diabetes mellitus after single-piece hydrophobic acrylic intraocular lens implantation 4 years postoperatively. METHODS In this prospective, observational case-control study carried out at Iladevi Cataract and IOL Research Centre, Ahmedabad, India, 75 consecutive eyes with diabetes mellitus (cases) were compared with 75 age-matched eyes with age-related cataract (controls). A detailed, preoperative and posterior segment evaluation was carried out in eyes with diabetes mellitus to detect the presence or absence of diabetic retinopathy (DR). The Mann-Whitney U-test was applied to compare the differences in the development of PCO between the two groups. RESULTS There was no difference in median PCO between cases and controls at 1 month (2.0 vs 1.50, P<0.068), but cases had a higher median PCO at 12 months (2.95 vs 1.30, P<0.001). At 4 years, there was no significant difference in median PCO between cases and controls (3.75 vs 2.25, P=0.273). The duration of diabetes increased the incidence of PCO at 4 years (P=0.02). Severity of DR had no influence on the progress of PCO at 4 years (P=0.69). CONCLUSION Diabetes mellitus did not increase the incidence of PCO at 4 years. The duration of diabetes increased the risk of PCO. The severity of retinopathy did not influence the development of PCO.
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Brookshire HL, English RV, Nadelstein B, Weigt AK, Gift BW, Gilger BC. Efficacy of COX-2 inhibitors in controlling inflammation and capsular opacification after phacoemulsification cataract removal. Vet Ophthalmol 2014; 18:175-85. [PMID: 24636042 DOI: 10.1111/vop.12159] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the efficacy of 0.9% bromfenac (Xibrom™) or a celecoxib-impregnated intraocular lens (celecoxib-IOL) compared with 1% prednisolone acetate (PA) in controlling postoperative inflammation and posterior capsule opacification (PCO). ANIMAL STUDIED Fifty-nine dogs undergoing cataract extraction by phacoemulsification. PROCEDURE Bilateral patients received bromfenac or celecoxib-IOL plus PA in one eye, and PA in the contralateral eye. Unilateral patients received bromfenac or PA. Complete ophthalmic examination including tonometry, slit-lamp grading of flare and PCO, and digital image acquisition for masked PCO evaluation was performed within 24 h and 1, 4, 12, 24, and 56 weeks following surgery. RESULTS Celecoxib-IOL/PA-treated eyes had significantly less flare than PA-treated eyes, which had significantly less flare than bromfenac-treated eyes 24 h postoperatively. There was no significant difference in intraocular pressure (IOP) postoperatively, or at 1, 24, or 56 weeks. Celecoxib-IOL/PA-treated eyes had significantly lower IOP measurements than bromfenac and PA-treated eyes at 4 and 12 weeks. There was no significant difference in PCO level between groups using slit-lamp biomicroscopy at any time point. Masked evaluation of digital images revealed significantly less PCO in celecoxib-IOL/PA- vs. bromfenac-treated eyes at 4 weeks, and in bromfenac- vs. PA-treated eyes at 56 weeks. CONCLUSIONS Eyes receiving celecoxib-IOL/PA had better initial control of inflammation. Bromfenac was equally effective compared with PA in controlling inflammation. There was no association between COX-2 inhibitor administration and ocular hypertension. Celecoxib-IOL/PA-treated eyes showed better initial control of PCO (up to 12 weeks), while eyes receiving bromfenac had better long-term control of PCO (56 weeks).
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Matsushima H, Iwamoto H, Mukai K, Katsuki Y, Nagata M, Senoo T. Preventing secondary cataract and anterior capsule contraction by modification of intraocular lenses. Expert Rev Med Devices 2014; 5:197-207. [DOI: 10.1586/17434440.5.2.197] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Leydolt C, Schriefl S, Stifter E, Haszcz A, Menapace R. Posterior capsule opacification with the iMics1 NY-60 and AcrySof SN60WF 1-piece hydrophobic acrylic intraocular lenses: 3-year results of a randomized trial. Am J Ophthalmol 2013; 156:375-381.e2. [PMID: 23677137 DOI: 10.1016/j.ajo.2013.04.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 04/04/2013] [Accepted: 04/05/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the intensity of posterior capsule opacification (PCO) 3 years after implantation of 2 different 1-piece foldable hydrophobic acrylic intraocular lenses (IOLs). DESIGN Randomized, prospective, patient- and examiner-masked clinical trial with intraindividual comparison. METHODS One hundred patients with bilateral age-related cataract (200 eyes) had standard cataract surgery with implantation of an iMics1 NY-60 IOL (Hoya Corp) in one eye and an AcrySof SN60WF IOL (Alcon Laboratories) in the other eye. Follow-up examinations were performed at 1 week and 3 years. Digital retroillumination images were obtained of each eye. The main outcome measure was PCO score (scale, 0 to 10) assessed subjectively at the slit lamp and objectively using automated image analysis software (Automated Quantification of After-Cataract) 3 years after surgery. RESULTS The objective PCO score (mean ± standard deviation) was 3.0 ± 2.0 for the iMics1 NY-60 IOL and 1.9 ± 1.4 for the AcrySof SN60WF IOL (P < .001). Three years after surgery, 35.6% of patients underwent a neodymium:yttrium-aluminum-garnet capsulotomy in the iMics1 NY-60 eye and 13.7% underwent a capsulotomy in the AcrySof SN60WF eye (P = .001). There was no statistically significant difference in best-corrected visual acuity, rhexis-IOL overlap, capsular folds, or anterior capsule opacification. Glistening formations were found in no iMics1 NY-60 IOLs, but in 97% of the AcrySof SN60WF IOLs. CONCLUSIONS Comparison of 2 sharp-edged single-piece IOLs of similar design and hydrophobic acrylic material indicated a statistically significant difference in PCO and neodymium:yttrium-aluminum-garnet capsulotomy rate 3 years after surgery.
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Visser N, Bauer NJC, Nuijts RMMA. Toric intraocular lenses: historical overview, patient selection, IOL calculation, surgical techniques, clinical outcomes, and complications. J Cataract Refract Surg 2013; 39:624-37. [PMID: 23522584 DOI: 10.1016/j.jcrs.2013.02.020] [Citation(s) in RCA: 176] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 08/02/2012] [Accepted: 08/03/2012] [Indexed: 11/17/2022]
Abstract
We present an overview of currently available toric intraocular lenses (IOLs) and multifocal toric IOLs. Relevant patient selection criteria, IOL calculation issues, and surgical techniques for IOL implantation are discussed. Clinical outcomes including uncorrected visual acuity, residual refractive astigmatism, and spectacle independency, which have been reported for both toric IOLs and multifocal toric IOLs, are reviewed. The incidence of misalignment, the most important complication of toric IOLs, is determined. Finally, future developments in the field of toric IOLs are discussed.
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Affiliation(s)
- Nienke Visser
- University Eye Clinic, Maastricht University Medical Center, Maastricht, the Netherlands.
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Etiology of surface light scattering on hydrophobic acrylic intraocular lenses. J Cataract Refract Surg 2013; 38:1833-44. [PMID: 22999603 DOI: 10.1016/j.jcrs.2012.05.043] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Revised: 05/09/2012] [Accepted: 05/09/2012] [Indexed: 11/20/2022]
Abstract
PURPOSE To study the etiology of surface light scattering on hydrophobic acrylic intraocular lenses (IOLs). SETTING Alcon Research Laboratories, Fort Worth, Texas, USA. DESIGN Experimental study. METHODS Intraocular lenses were obtained from clinical explantations (n = 5), from human cadavers (n = 8), and from finished-goods inventory (controls). Surface light scattering was measured and imaged with the IOLs in various hydration states (dry, short-term wetted, and long-term hydrated) before and after proteins were quantified and removed. Selected IOL samples were analyzed with x-ray photoelectron spectroscopy, scanning electron microscopy (SEM) with energy-dispersion x-ray analysis, Fourier-transform infrared spectroscopy with attenuated total reflectance, and cryogenic SEM with a focused ion beam. RESULTS No inorganic deposits or organic changes were observed on any IOL surface. Under clinically relevant hydrated conditions, surface light-scattering intensity was independent of proteinaceous biofilm state (P≥.11). Instead, the hydration state of the IOLs significantly contributed to the intensity of surface light scattering (P<.001); clinically explanted and cadaver-eye IOLs (but not control IOLs) exhibited minimal scatter when dry, intermediate scatter when wetted, and maximum scatter when hydrated. Subsurface nanoglistenings with diameters less than a micron and with locations up to 120 μm from the surface of the IOLs were characterized by SEM with a focused ion beam and were identified as the source of the hydration-related surface light scattering. CONCLUSION Surface light scattering on hydrophobic IOLs was predominantly caused by hydration-related subsurface nanoglistenings within the acrylic IOL material.
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Intraocular Lens Implants: A Scientific Perspective. Biomater Sci 2013. [DOI: 10.1016/b978-0-08-087780-8.00078-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Silicone intraocular lens surface calcification in a patient with asteroid hyalosis. Jpn J Ophthalmol 2012; 56:319-23. [PMID: 22573067 DOI: 10.1007/s10384-012-0124-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 12/01/2011] [Indexed: 10/28/2022]
Abstract
PURPOSE To confirm a substance presence on the posterior intraocular lens (IOL) surface in a patient with asteroid hyalosis. METHODS An 80-year-old man had IOLs for approximately 12 years. Opacities and neodymium-doped yttrium aluminum garnet pits were observed on the posterior surface of the right IOL. Asteroid hyalosis and an epiretinal membrane were observed OD. An IOL exchange was performed on 24 March 2008, and the explanted IOL was analyzed using a light microscope and a transmission electron microscope with a scanning electron micrograph and an energy-dispersive X-ray spectrometer for elemental analysis. To confirm asteroid hyalosis, asteroid bodies were examined with the ionic liquid (EtMeIm+ BF4-) method using a field emission scanning electron microscope (FE-SEM) with digital beam control RGB mapping. RESULTS X-ray spectrometry of the deposits revealed high calcium and phosphorus peaks. Spectrometry revealed that the posterior IOL surface opacity was due to a calcium-phosphorus compound. Examination of the asteroid bodies using FE-SEM with digital beam control RGB mapping confirmed calcium and phosphorus as the main components. CONCLUSIONS Calcium hydrogen phosphate dihydrate deposits were probably responsible for the posterior IOL surface opacity. Furthermore, analysis of the asteroid bodies demonstrated that calcium and phosphorus were its main components.
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Reply:. Cornea 2012. [DOI: 10.1097/ico.0b013e31822fff31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Nagata M, Matsushima H, Mukai K, Terauchi W, Senoo T, Wada H, Yoshida S. Clinical evaluation of the transparency of hydrophobic acrylic intraocular lens optics. J Cataract Refract Surg 2011; 36:2056-60. [PMID: 21111307 DOI: 10.1016/j.jcrs.2010.06.064] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 06/22/2010] [Accepted: 06/22/2010] [Indexed: 11/19/2022]
Abstract
PURPOSE To clinically evaluate postoperative changes in the transparency of hydrophobic acrylic intraocular lenses (IOLs). SETTING Department of Ophthalmology, Dokkyo Medical University, Tochigi, Japan. DESIGN Case-control study. METHODS Eyes having phacoemulsification were randomly assigned to have implantation of 1 of 3 hydrophobic acrylic IOL models. The IOLs were photographed at 0 degree and 90 degrees 1 week, 6 months, and 1 year after implantation using a Nidek EAS-1000 anterior chamber analyzer in slit mode. The images were used to determine the intensity of light scattering in the surface and middle regions of the IOL optic. RESULTS The study comprised 65 eyes of 57 patients with a mean age of 72.5 years. The rate of increase in light-scattering intensity was similar in the middle and surface regions of the Tecnis ZA9003 aspheric IOL. The increase in light-scattering intensity in both regions of the AF-1 VA-60BB spherical IOL was greater than that in the aspheric IOL at all the measurement points. The intensity of light scattering was highest and tended to increase over time in both regions of the AcrySof SA60AT spherical IOL; the rate of increase in intensity was higher in the surface region than in the middle region, and the difference was significantly greater at 6 months and 1 year than at 1 week. CONCLUSION Our results suggest that AcrySof SA60AT and AF-1 VA-60BB IOLs are likely to develop glistenings over time and that the former may develop whitening.
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Affiliation(s)
- Mayumi Nagata
- Department of Ophthalmology, Dokkyo Medical University, Tochigi, Japan
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Prinz A, Neumayer T, Buehl W, Vock L, Menapace R, Findl O, Georgopoulos M. Rotational stability and posterior capsule opacification of a plate-haptic and an open-loop-haptic intraocular lens. J Cataract Refract Surg 2011; 37:251-7. [DOI: 10.1016/j.jcrs.2010.08.049] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 08/18/2010] [Accepted: 08/22/2010] [Indexed: 10/18/2022]
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Abela-Formanek C, Amon M, Kahraman G, Schauersberger J, Dunavoelgyi R. Biocompatibility of hydrophilic acrylic, hydrophobic acrylic, and silicone intraocular lenses in eyes with uveitis having cataract surgery: Long-term follow-up. J Cataract Refract Surg 2011; 37:104-12. [DOI: 10.1016/j.jcrs.2010.07.038] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Revised: 01/15/2010] [Accepted: 07/21/2010] [Indexed: 11/29/2022]
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Holland E, Lane S, Horn JD, Ernest P, Arleo R, Miller KM. The AcrySof Toric Intraocular Lens in Subjects with Cataracts and Corneal Astigmatism. Ophthalmology 2010; 117:2104-11. [DOI: 10.1016/j.ophtha.2010.07.033] [Citation(s) in RCA: 161] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Revised: 07/19/2010] [Accepted: 07/28/2010] [Indexed: 10/19/2022] Open
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Mamalis N, Grossniklaus HE, Waring GO, Werner L, Brubaker J, Davis D, Espandar L, Walker R, Thyzel R. Ablation of lens epithelial cells with a laser photolysis system: histopathology, ultrastructure, and immunochemistry. J Cataract Refract Surg 2010; 36:1003-10. [PMID: 20494774 DOI: 10.1016/j.jcrs.2009.11.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Revised: 11/18/2009] [Accepted: 11/19/2009] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate efficacy of a neodymium:YAG (Nd:YAG) laser photolysis system in removing lens epithelial cells (LECs) and characterize the effect of the laser on laminin and fibronectin involved in LEC adhesion and migration. METHODS Cadaver eyes were evaluated using the Miyake technique. The lenses were removed with phacoemulsification. The modified Nd:YAG laser was used to clean the LECs from the capsule. Only the fornix was cleaned in some eyes and the anterior subcapsular area in other eyes. Some areas were not treated and acted as controls. Standard irrigation/aspiration (I/A) removal of LECs was performed in additional eyes. The eyes were analyzed using light microscopy and immunohistochemical staining. RESULTS Histopathologic evaluation showed that the laser removed the LECs from the anterior lens capsule and from the fornix. Immunohistochemical staining showed fibronectin and laminin staining in the untreated areas that was absent in the treated areas. Standard I/A removal of the LECs showed absence of cells but persistent laminin and fibronectin. Electron microscopy showed epithelial cells in untreated areas with an absence of the LECs and debris in treated areas. CONCLUSIONS The laser photolysis system removed LECs from the anterior lens capsule and capsule fornix. Along with the cells, laminin, fibronectin, and cell debris remained in the untreated areas but were removed by the treatment. This treatment may be useful in preventing posterior capsule opacification.
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Affiliation(s)
- Nick Mamalis
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah 84132, USA.
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Baillif S, Hartmann D, Freney J, Kodjikian L. [Intraocular lens and bacterial adhesion: influence of the environmental factors, the characteristics of the bacteria, and the target material surface]. J Fr Ophtalmol 2010; 33:210-21. [PMID: 20202716 DOI: 10.1016/j.jfo.2010.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2009] [Accepted: 12/22/2009] [Indexed: 10/19/2022]
Abstract
Adhesion of bacteria to intraocular lenses is an important step in the pathogenesis of postoperative endophthalmitis. It can be described as a two-phase process including an initial, instantaneous, and reversible phase followed by a time-dependant and irreversible molecular and cellular phase. The binding of bacteria is affected by many factors including environmental factors such as medium composition, presence of proteins and flow conditions, the bacterial cell surface characteristics, and the material's surface properties. This article reviews all these factors affecting the adhesion of bacteria to intraocular lenses. A better understanding of these mechanisms would make it possible to reduce the bacterial adhesion process and thus could help decrease the incidence of postoperative endophthalmitis.
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Affiliation(s)
- S Baillif
- Département d'Ophtalmologie, Centre hospitalo-universitaire Saint Roch, Nice, France; Laboratoire "Réparation Tissulaire, Interactions Biologiques et Biomatériaux", UPSP 2007.03.135 RTI2B, Lyon, France
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