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Heiligenhaus A, Bertram B, Baquet-Walscheid K, Becker M, Deuter C, Ness T, Ostrowski A, Pleyer U. [Non-infectious anterior uveitis : S1 guideline of the German Society of Ophthalmology (DOG) and the German Professional Association of Ophthalmologists (BVA). Version: 13.12.2023]. DIE OPHTHALMOLOGIE 2024:10.1007/s00347-024-02007-7. [PMID: 38438812 DOI: 10.1007/s00347-024-02007-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/02/2024] [Indexed: 03/06/2024]
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Chen S, Yuan G, Zhu W, Wang Q, Shi W, Zhang J. Four-Point Scleral Fixation of An Akreos Adapt AO Intraocular Lens Using Double-Strand 9-0 Polypropylene Suture. Retina 2023; 43:2059-2063. [PMID: 35982505 PMCID: PMC10659248 DOI: 10.1097/iae.0000000000003601] [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: 03/17/2022] [Accepted: 07/28/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To report the results of a novel surgical four-point transscleral suture fixation of intraocular lens (IOL) with four hollow haptics using the double-suture technique. METHODS We retrospectively reviewed the medical records of 15 eyes of 15 patients who underwent 4-point transscleral suture fixation of a foldable IOL using the double-suture technique. Preoperative data and follow-up data for at least 4 months were collected for all patients. RESULTS The IOLs were fixed and centered well. The mean preoperative corrected distance visual acuity was 0.70 ± 0.54 logarithm of the minimum angle of resolution (Snellen 20/102), and it improved to 0.29 ± 0.26 logarithm of the minimum angle of resolution (Snellen 20/39) at the final follow-up ( P = 0.001). No vitreous hemorrhage, hypotony, suture breakage, retinal detachment, IOL dislocation, and iris capture was detected during the follow-up period in any of the patients. CONCLUSION We have developed a novel technique for 4-point transscleral suture fixation of IOL using the double-suture technique with 9-0 polypropylene suture. This technique seemed to be safe and it may not require the surgeon to learn any new technique.
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Itoh K. Stainability of Acrylic Intraocular Lens With Brilliant Blue G: An In Vitro Study. Am J Ophthalmol 2023; 254:104-113. [PMID: 37406844 DOI: 10.1016/j.ajo.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE To evaluate the stainability of several acrylic intraocular lens (IOLs) with Brilliant Blue G (BBG) in vitro. DESIGN Clinically relevant, laboratory, experimental study. METHODS LS313MF15 as a hydrophilic acrylic IOL and X-70, W60R, CP2.2R, YP2.2R, XC1, and XY1 as hydrophobic acrylic IOLs were included in this study. Prepared acrylic IOLs were evaluated for staining via immersion for different periods in BBG solution with adjusted concentrations. In cases where IOLs were stained blue, the sustained release of BBG and IOL cross-sectional images were evaluated, as well as changes in the optical properties of the IOLs via spectrophotometry. RESULTS All acrylic IOLs were stained with BBG in a BBG concentration- and staining time-dependent manner, with almost no sustained release of BBG observed. Lenses with a higher water content exhibited more pronounced staining, and BBG penetrated into the IOLs. A decrease in light transmittance with a peak wavelength of 610 to 620 nm was observed in blue-stained IOLs. LS313MF15 was markedly blue stained even with a short period of staining. CONCLUSIONS Any acrylic IOL can be stained with BBG, but hydrophilic IOLs are particularly susceptible to blue staining. Precautions should be taken in surgeries requiring the use of BBG staining, and efforts should be made to ensure that BBG components are sufficiently washed out intraoperatively.
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Affiliation(s)
- Kaku Itoh
- From the Departments of Ophthalmology, Muroran City General Hospital, Muroran City, Hokkaido, Japan (K.I.).
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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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Wang Y, Wang W, Zhu Y, Xu J, Luo C, Yao K. Comparison Study of Anterior Capsule Contraction of Hydrophilic and Hydrophobic Intraocular Lenses Under the Same Size Capsulotomy. Transl Vis Sci Technol 2022; 11:24. [PMID: 35040916 PMCID: PMC8764210 DOI: 10.1167/tvst.11.1.24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To compare anterior capsule contraction of two kinds of hydrophilic and hydrophobic acrylic intraocular lenses (IOLs) under the same size capsulotomy with femtosecond laser-assisted cataract surgery (FLACS). Methods A total of 320 eyes in 320 patients who underwent FLACS were included. The patients were scheduled to have hydrophilic acrylic IOLs (MI60, 509M) and hydrophobic acrylic IOLs (iSert250, ZCB00) implanted. Visual acuity and anterior segment photography using a slit lamp microscope were performed at postoperative one week, one month, three months, and one year. Results The contraction of the anterior capsule opening area (mm2) and circumference (mm) in the hydrophilic group were larger than that of the hydrophobic group from postoperative one week to one year (P < 0.001, P < 0.001, respectively). The postoperative contraction of the capsule opening area in MI60 was larger than in 509M (P < 0.001) and larger in 509M than in iSert250 and ZCB00 (P = 0.008, P = 0.019, respectively), but no difference was observed between iSert250 and ZCB00 (P = 0.867). During postoperative one to three months, all groups had the maximum capsule contraction (P < 0.001). Conclusions Under the same size capsulotomy with FLACS, the postoperative anterior capsule contraction induced by hydrophobic IOLs was less than that induced by hydrophilic IOLs. Among the four IOLs, the capsule contraction was largest in MI60, followed by 509M, and least in iSert250 and ZCB00, which was time-dependent. Translational Relevance Our findings implied that patients with a high risk of ACC should choose hydrophobic IOLs, as well as nonsteroidal anti-inflammatory drugs may be used for a longer period in patients with high risk of capsule contraction syndrome.
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Affiliation(s)
- Yuyan Wang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Wei Wang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Yanan Zhu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Jia Xu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Chenqi Luo
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
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Latham SG, Carr F, Ali H, Gangwani V. Clinical safety and efficacy of a preloaded monofocal hydrophobic acrylic intraocular lens in a real-world population. BMC Ophthalmol 2021; 21:379. [PMID: 34696772 PMCID: PMC8543946 DOI: 10.1186/s12886-021-02142-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 09/23/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This study was designed to evaluate visual, refractive and safety outcomes in eyes after they underwent phacoemulsification and implantation of a preloaded monofocal hydrophobic acrylic intraocular lens. METHODS This was a single center observational study conducted at Ashford and St Peter's Hospitals NHS Foundation Trust, United Kingdom. Patients were included if they had cataract extraction with in-the-bag implantation of the EyeCee® One preloaded intraocular lens from August to October 2019. Pre-operative, surgery-related and 2 weeks and 3 months post-operative data was collected. Surgeons at this trust were then asked to complete a feedback form to evaluate their experience of implanting the EyeCee® One. RESULTS One hundred fifty-two eyes were included in the study. Ninety-four (62%) of these eyes had cataract but no concomitant ocular pathology that could potentially affect visual acuity. Three months post-operatively, 98.7% of all eyes had monocular CDVA ≤0.3 logMAR. 100% of the eyes without concomitant ocular pathology achieved this target. The mean CDVA of all eyes in this study improved from 0.43 ± 0.43 logMAR pre-operatively, to 0.05 ± 0.11 logMAR post-operatively (p < 0.05). The mean sphere and spherical equivalent values showed significant improvements (p < 0.05) and (p < 0.05). There were no intraoperative complications and 1.3% of patients reported complications 2 weeks post-operatively. All of the participating surgeons said they would use the EyeCee® One again with 64% providing an overall rating of 'excellent' for their experience of implanting this intraocular lens. CONCLUSIONS This study indicates excellent post-operative visual acuity and refractive outcomes in eyes after EyeCee® One implantation. This is accompanied with very little risk of intraoperative and post-operative complications.
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Affiliation(s)
| | - Francis Carr
- Ashford and St Peter's Hospitals NHS Foundation Trust, Ashford, UK
| | - Hala Ali
- Ashford and St Peter's Hospitals NHS Foundation Trust, Ashford, UK
| | - Vinod Gangwani
- Ashford and St Peter's Hospitals NHS Foundation Trust, Ashford, UK
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Rajesh SJ. Study on buckling of intraocular lens haptic in 2 types of intraocular lens material and its effect on vision. Rom J Ophthalmol 2021; 64:387-395. [PMID: 33367176 PMCID: PMC7739026 DOI: 10.22336/rjo.2020.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aim: To study the buckling of intraocular lens (IOL) haptics and its effect on vision in patients implanted with either hydrophilic or hydrophobic lens material. Study design: Prospective, observational and descriptive study. Setting: Tertiary eye care center in India. Material and methods: Patients operated for age-related cataract by phacoemulsification technique implanted with hydrophilic or hydrophobic IOL came either for follow-up surgery or complaints in an operated eye, being examined for visual acuity, refraction, anterior segment evaluation, and retinal examination. The position of IOL in terms of optic and haptics was noted and photographed. Results: 317 patients participated in the study. The mean age (SD) of the patients was 65 years (± 4.5). Of 317 patients, 127 (254 eyes) had bilateral, and 190 (190 eyes) had one eye IOL implantation. Out of 444 eyes, 254 (57.2 %) had hydrophilic and 190 eyes (42.8%) had hydrophobic IOL implantation. Buckling of IOL haptic was seen in 37 (8.3%) eyes of which 34 (13.9%) had hydrophilic, and 3 (1.6%) had hydrophobic IOL. Maximum eyes (n=20) with hydrophilic IOL presented during 1-3 years after IOL implantation. Major complaint for which patients came for follow up was blurring of vision (48.9%) and diminished vision (36.3%). Posterior capsular opacification (PCO) was observed in 2/ 190 (1.1%) eyes with hydrophobic and 28/ 254 (11%) eyes with hydrophilic IOL. Discussion: The present study dealt with the long-term performance of the haptics of the hydrophilic and hydrophobic IOLs in relation to its stability in the capsular bag. Conclusion: Buckling of haptic was seen more in the hydrophilic than in the hydrophobic IOLs. PCO was common in these eyes. Change in refraction occurred in eyes with hydrophilic IOL with buckling.
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Affiliation(s)
- Subhash Joshi Rajesh
- Department of Ophthalmology, Vasantrao Naik Government Medical College, Maharashtra, India
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Junqueira NB, Chaves LJ, Poli-Neto O, Scott IU, Jorge R. Scleral fixation using a hydrophilic four-haptic lens and polytetrafluoroethylene suture. Sci Rep 2021; 11:15793. [PMID: 34349221 PMCID: PMC8339062 DOI: 10.1038/s41598-021-95428-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
To assess the safety of scleral fixation using the Akreos AO60 intraocular lens (IOL) and Gore-Tex suture. Prospective evaluation of 20 patients who underwent scleral fixation of an Akreos AO60 with Gore-Tex. Patients presenting with aphakia or dislocated IOL without capsular support were enrolled in the study. Main outcome measures included visual acuity, endothelial cell density, and postoperative complications over 6 months of follow-up. Mean ± standard deviation (SD) uncorrected logMAR visual acuity improved from 1.92 ± 0.23 (20/1600 Snellen equivalent) preoperatively to 0.80 ± 0.56 (20/125) at 6 months postoperatively (p < 0.001). Mean ± SD best-corrected visual acuity (BCVA) logMAR was 0.43 ± 0.23 preoperatively and 0.37 ± 0.24 (20/50) at 3-6 months postoperatively (p = 0.312). The mean ± SD endothelial cell density was 1740.50 ± 522.92 cells/mm2 and 1187.19 ± 493.00 cells/mm2 (p < 0.001) pre and postoperatively, respectively. Mean ± SD postoperative spherical equivalent was - 1.12 ± 1.50D. Postoperative complications included exposure of suture in 40% of the patients, hypotony in 15%, ocular hypertension in 10%, transient vitreous hemorrhage in 10%, retinal detachment in 5%, and transient lens opacification in 5%. Scleral fixation with an Akreos AO60 and Gore-Tex appears generally safe. However, given the high incidence of suture erosion observed, the use of scleral flaps or rotating and burying the knots is recommended in order to reduce the risk of this complication.
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Affiliation(s)
- Natacha B Junqueira
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil.,Federal University of Mato Grosso Do Sul, Três Lagoas, MS, Brazil
| | - Leandro J Chaves
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - Omero Poli-Neto
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil
| | - Ingrid U Scott
- Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Rodrigo Jorge
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil.
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Altinkurt E, Sayar Bilgin G. Scleral fixation of hydrophobic acrylic intraocular lenses using a suture burial technique. Indian J Ophthalmol 2021; 69:1600-1604. [PMID: 34011750 PMCID: PMC8302312 DOI: 10.4103/ijo.ijo_3151_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The procedure involved an ab-externo scleral fixation technique using a double-armed 10-0 polypropylene suture with straight needles that require no scleral flaps. The IOLs are sutured to the sclera, the free suture ends are tied to the suture loops, and they are buried together under the sclera. Forty eyes of 37 patients were included. Postoperative complications are IOL capture in five eyes (12.5%), a significant IOL tilt in one eye (2.5%), recurrent UGH (uveitis-glaucoma-hyphema) syndrome in two eyes (5%), glaucoma in three eyes (7.5%), suture exposure in two eyes (5%) and IOL drop due to haptic breakage in one eye (2.5%). The technique can be effectively used for the refixation of dislocated hydrophobic acrylic IOLs by temporary haptic externalization through a corneal incision and for the treatment of aphakia with or without penetrating keratoplasty. Surgeons should be aware of the possibility of UGH syndrome due to IOL capture, especially in young eyes.
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Affiliation(s)
- Emre Altinkurt
- Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology, Istanbul, Turkey
| | - Gizem Sayar Bilgin
- Istanbul University, Istanbul Faculty of Medicine, Department of Ophthalmology, Istanbul, Turkey
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Hou C, Li H, Li J, Li J, Peng H, Wang Q. Artisan versus Artiflex phakic intraocular lens implantation in the treatment of moderate to high myopia: meta-analysis. BMC Ophthalmol 2021; 21:171. [PMID: 33838655 PMCID: PMC8035774 DOI: 10.1186/s12886-021-01930-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background To compare the postoperative safety, efficacy, predictability, visual quality and biomechanics after implantation of Artisan vs. Artiflex phakic intraocular lenses (PIOLs). Methods Pubmed, Embase, Cochrane Library were conducted up from January 2000 to February 2020. Comparative clinical studies reporting in accordance with the eligibility criteria were included in this meta-analysis. The pooled weighted mean differences (WMDs) and odds ratios (ORs) with corresponding 95% confidence intervals were calculated. Results Comparative trials with myopia patients were selected in this review. The pooled WMD and OR estimates statistical significance in terms of postoperative best corrected visual acuity (BCVA), efficacy, postoperative spherical equivalence (SE), predictability, contrast sensitivity and mean intraocular higher-order aberrations (HOA) (mm) for a 6-mm pupil, manifesting that Artiflex PIOL showed evident beneficial effect for correcting myopia compared to Artisan PIOL. There was no significant difference in the incidence of complications between the two groups. Conclusion Both of two techniques were safe and effective for myopia and compared to Artisan PIOL, Artiflex PIOL had significant improvement in efficacy, predictability, contrast sensitivityand HOA, except safety and complications in the treatment of moderate to high myopia. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01930-6.
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Affiliation(s)
- Chenting Hou
- Department of Ophthalmology, the Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266000, Shandong Province, China
| | - Hui Li
- Department of Ophthalmology, the First People's Hospital of Anqing, Anqing, Anhui Province, China.,the Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Jiangfeng Li
- Department of Ophthalmology, the Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266000, Shandong Province, China
| | - Jinjian Li
- Department of Ophthalmology, the Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266000, Shandong Province, China
| | - Hui Peng
- Department of Ophthalmology, the Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266000, Shandong Province, China
| | - Qing Wang
- Department of Ophthalmology, the Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, 266000, Shandong Province, China.
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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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12
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Ozates S, Berker N, Cakar Ozdal P, Ozdamar Erol Y. Phacoemulsification in patients with uveitis: long-term outcomes. BMC Ophthalmol 2020; 20:109. [PMID: 32183739 PMCID: PMC7079372 DOI: 10.1186/s12886-020-01373-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 03/06/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND To assess the long-term outcomes of phacoemulsification and intraocular lens (IOL) implantation in eyes with uveitis. METHODS One hundred and five eyes of 81 patients, who underwent phacoemulsification and IOL implantation between January 2009 and July 2016, were included in this study. The demographic data, preoperative clinical findings, postoperative outcomes, and intraoperative and postoperative complications were recorded. All collected data and risk factors with regard to visual prognosis were analyzed with the help of the Statistical Package for the Social Sciences version 20.0 software program (IBM Corp., Armonk, NY, USA). RESULTS During follow-up (mean: 35.2 ± 22.2 months), corrected distance visual acuity (CDVA) improved in 87.7% of all eyes and reached a level of 0.3 LogMAR or greater in 61.3% of eyes. Postoperative complications included posterior capsule opacification (50.9%), posterior synechiae (21.7%), cystoid macular edema (16%), epiretinal membrane (13.2%), glaucoma (11.3%), increased intraocular pressure (8.5%), and severe inflammation (6.6%). Uveitis recurred in 55.7% of all eyes. The risk for the development of cystoid macular edema was found to be associated with recurrence in the early postoperative period. Low visual acuity risk was 11.1-fold higher with macular scarring (p = 0.001) and 14-fold higher with optic atrophy (p < 0.001), respectively. CONCLUSIONS With appropriate management during the pre- and postoperative periods, phacoemulsification and IOL implantation surgery can be safe and effective in eyes with uveitis. However, great caution must be taken to prevent complications both before and after the surgery.
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Affiliation(s)
- Serdar Ozates
- Department of Ophthalmology, Kars Harakani State Hospital, Yenişehir Mahallesi, İsmail Aytemiz Blv. No:55, 36200, Merkez, Kars, Turkey.
| | - Nilufer Berker
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Pinar Cakar Ozdal
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Yasemin Ozdamar Erol
- Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
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Polischuk A, Kozyar V. Construction Solutions to Prevent Development of Secondary Cataract After Intraocular Lenses Implantation. INNOVATIVE BIOSYSTEMS AND BIOENGINEERING 2020. [DOI: 10.20535/ibb.2020.4.1.187310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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14
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Koch CR, Santhiago MR, Jorge PA, Sena P, Kara-Júnior N. Posterior Capsule Opacification after Cataract Surgery in Children Over Five Years of Age with Square-edge Hydrophobic versus Hydrophilic Acrylic Intraocular Lenses: A Prospective Randomized Study. Clinics (Sao Paulo) 2020; 75:e1604. [PMID: 32401967 PMCID: PMC7196726 DOI: 10.6061/clinics/2020/e1604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/29/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To compare the effects of hydrophobic and hydrophilic materials in square-edged acrylic intraocular lenses (IOLs) on the development of posterior capsule opacification (PCO) after pediatric cataract surgery. METHODS Patients were randomly assigned to group 1 (hydrophobic acrylic square-edged IOLs; 13 eyes) or group 2 (hydrophilic acrylic square-edged IOLs; 13 eyes). The study evaluated PCO rates using Evaluation of Posterior Capsule Opacification (EPCO) 2000 software at one, three, six and 12 months postoperatively. Postoperative measurements also included corrected distance visual acuity (CDVA), neodymium:yttrium-aluminum-garnet (Nd:YAG) capsulotomy and postoperative complications other than PCO. RESULTS Both groups had significant increases in PCO rates after one year. Comparison of the groups showed no significant differences in the EPCO scores at three (group 1, 0.007±0.016 vs group 2, 0.008±0.014; p=0.830), six (group 1, 0.062±0.103 vs group 2, 0.021±0.023; p=0.184), or twelve months postoperatively (group 1, 0.200±0.193 vs group 2, 0.192±0.138; p=0.902). We also found no significant group differences regarding the change (delta, Δ) in EPCO scores between three and six months (group 1, 0.055±0.09 vs group 2, 0.013±0.02; p=0.113) or between six and twelve months postoperatively (group 1, 0.139±0.14 vs group 2, 0.171±0.14; p=0.567). Twenty-three percent of patients required Nd:YAG capsulotomy at the twelve-month visit. CONCLUSIONS No differences in PCO rates were found between hydrophobic and hydrophilic acrylic square-edged IOLs in children between five and twelve years of age at one year of follow-up.
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Affiliation(s)
- Camila Ribeiro Koch
- Departamento de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- Hospital Humberto Castro Lima, Salvador, BA, BR
- Corresponding author. E-mail:
| | - Marcony R Santhiago
- Departamento de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- University of Southern California Roski Eye Institute, Los Angeles, CA, USA
- Departamento de Oftalmologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Priscilla A Jorge
- Departamento de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Paulo Sena
- Hospital Humberto Castro Lima, Salvador, BA, BR
| | - Newton Kara-Júnior
- Departamento de Oftalmologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
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Belin PJ, Raouf S, Lieberman RM. Innovations in Secondary Intraocular Lens Placement. ADVANCES IN OPHTHALMOLOGY AND OPTOMETRY 2019; 4:177-191. [DOI: 10.1016/j.yaoo.2019.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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16
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Yoon MH, Kim SY, Chin HS. Late Postoperative Opacification of Multifocal Intraocular Lens after Vitrectomy in a Diabetic Patient. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.12.1329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Myung Hun Yoon
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea
| | - Se Young Kim
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea
| | - Hee Seung Chin
- Department of Ophthalmology, Inha University School of Medicine, Incheon, Korea
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Jonker SM, Berendschot TT, Ronden AE, Saelens IE, Bauer NJ, Nuijts RM. Five-Year Endothelial Cell Loss After Implantation With Artiflex Myopia and Artiflex Toric Phakic Intraocular Lenses. Am J Ophthalmol 2018; 194:110-119. [PMID: 30053473 DOI: 10.1016/j.ajo.2018.07.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 07/12/2018] [Accepted: 07/15/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To evaluate the long-term changes in endothelial cell density (ECD) after the implantation of 2 types of foldable iris-fixated phakic intraocular lenses (pIOLs) for the treatment of myopia and astigmatism. DESIGN Prospective clinical cohort study. METHODS Two-hundred and ninety-three and 188 eyes implanted with, respectively, the Artiflex Myopia and Artiflex Toric (Ophtec B.V., Groningen, The Netherlands) iris-fixated pIOL for the treatment of myopia or astigmatism at the University Eye Clinic Maastricht as of January 2004. One-hundred and forty-six eyes from the myopic and 64 eyes from the toric groups completed a 5-year follow-up. Main outcome measures were chronic endothelial cell (EC) loss, percentage of eyes with a ≥25% decrease in ECD, and the percentage of eyes with an ECD < 1500 cells/mm2. RESULTS Chronic EC loss showed an annual decline of 64 cells/mm2 in the myopic (P < .001, standard error 3.58) and 62 cells/mm2 in the toric (P < .001, standard error 3.77) groups. Total chronic EC loss from 6 months to 5 years postoperatively was 10.5% in the myopic and 10.2% in the toric groups. After 5 years, an ECD decrease of ≥25% occurred in 4.4% and 4.3% of eyes, and an ECD < 1500 cells/mm2 was reported in 3.0% and 0.0% of eyes, respectively. Explantation of a pIOL owing to EC loss was required in 3.1% and 0% of eyes. CONCLUSION Chronic EC loss was around 10% over a 5-year period in eyes implanted with the foldable myopic (toric) pIOL. In up to 3.1% of eyes significant EC loss resulted in subsequent pIOL explantation.
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Clinical outcomes of combined pars plana vitrectomy and trans-scleral 4-point suture fixation of a foldable intraocular lens. Eye (Lond) 2018; 32:1055-1061. [PMID: 29398696 DOI: 10.1038/s41433-018-0018-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 11/28/2017] [Accepted: 12/05/2017] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To describe outcomes of combined pars plana vitrectomy (PPV) and trans-scleral 4-point suture fixation of a foldable Akreos AO60 intraocular lens (IOL) in eyes with subluxated or dislocated lens or IOL. METHODS Retrospective case series of 20 eyes of 18 patients who underwent this procedure with a minimum follow-up of 3 months. Outcome measures included final best-corrected Snellen visual acuity (BCVA), spherical equivalent (SE) and intraoperative and postoperative complications. RESULTS Mean age at surgery was 43.65 years. The commonest indication for surgery was post-traumatic subluxated or dislocated cataract. Mean BCVA improved from 6/24 preoperatively to 6/9 at final follow-up (p < 0.0001). Mean SE was 5.69 dioptres preoperatively and -1.32 dioptres postoperatively. There were no intraoperative complications. Postoperative complications included transient vitreous haemorrhage in one eye and cystoid macular oedema in one eye. Postoperative Pentacam analysis confirmed the absence of IOL tilt or decentration in six eyes. Mean follow-up was 8.9 months (range 3-30 months). CONCLUSION Trans-scleral 4-point suture fixation of a foldable Akreos AO60 IOL can be performed safely along with concurrent PPV across varying surgical indications resulting in a substantial improvement in visual acuity with minimal complications.
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Yoeruek E, Deuter C, Gieselmann S, Saygili O, Spitzer MS, Tatar O, Bartz-Schmidt KU, Szurman P. Long-Term Visual Acuity and its Predictors after Cataract Surgery in Patients with Uveitis. Eur J Ophthalmol 2018; 20:694-701. [DOI: 10.1177/112067211002000409] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose. To analyze the outcomes of phacoemulsification and posterior intraocular lens (IOL) implantation in patients with uveitis and to determine factors responsible for poor visual outcome. Methods. The records of 155 patients (180 eyes) with uveitis who had phacoemulsification and IOL implantation between August 2001 and March 2008 were examined retrospectively. Best-corrected visual acuity (BCVA) was recorded at the immediate preoperative visit and at follow-up examinations every 3 months. At each postoperative visit, a complete ophthalmologic examination was performed. The postoperative visual outcomes and complications were analyzed. Univariate regression analysis was done to determine risk factors for poor visual acuity during follow-up. Results. The mean follow-up was 31.4 months (range 3–78 months). An underlying systemic disease was present in 70 (45.2%) patients (82 eyes, 45.6%). The mean preoperative logMAR BCVA was 1.13±0.62 (95% CI: 0.85–1.02) and increased to 0.42±0.57 (95% CI: 0.32–0.59) at last medical visit (p<0.001). A total of 107 eyes (59.4%) had postoperative complications including posterior capsular opacification, newly developed macular edema, recurrence of uveitis, macular epiretinal membrane, and deposits on the IOL surface. Preoperatively observed macular lesions was the factor most strongly associated with poor visual outcome after cataract surgery (odds ratio: 5.43; 95% CI: 3.41–7.34; p<0.001). Anterior segment pathologies, age at surgery, etiology of uveitis (idiopathic, uveitis associated systemic disease), and gender did not influence visual rehabilitation after surgery (p>0.05). Conclusions. The outcomes of phacoemulsification and IOL implantation in patients with uveitis were satisfactory. Patients with observed preoperative macular lesions are at risk for poor visual outcome.
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Affiliation(s)
- Efdal Yoeruek
- University Eye Hospital, Centre of Ophthalmology, Eberhard-Karls University Tuebingen, Tuebingen - Germany
| | - Christoph Deuter
- University Eye Hospital, Centre of Ophthalmology, Eberhard-Karls University Tuebingen, Tuebingen - Germany
| | - Sylvia Gieselmann
- University Eye Hospital, Centre of Ophthalmology, Eberhard-Karls University Tuebingen, Tuebingen - Germany
| | - Oguzhan Saygili
- University Eye Hospital, Centre of Ophthalmology, Eberhard-Karls University Tuebingen, Tuebingen - Germany
| | - Martin S. Spitzer
- University Eye Hospital, Centre of Ophthalmology, Eberhard-Karls University Tuebingen, Tuebingen - Germany
| | - Olcay Tatar
- University Eye Hospital, Centre of Ophthalmology, Eberhard-Karls University Tuebingen, Tuebingen - Germany
| | - Karl U. Bartz-Schmidt
- University Eye Hospital, Centre of Ophthalmology, Eberhard-Karls University Tuebingen, Tuebingen - Germany
| | - Peter Szurman
- University Eye Hospital, Centre of Ophthalmology, Eberhard-Karls University Tuebingen, Tuebingen - Germany
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Özyol P, Özyol E, Karel F. Biocompatibility of Intraocular Lenses. Turk J Ophthalmol 2017; 47:221-225. [PMID: 28845327 PMCID: PMC5563551 DOI: 10.4274/tjo.10437] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 07/27/2016] [Indexed: 02/07/2023] Open
Abstract
The performance of an intraocular lens is determined by several factors such as the surgical technique, surgical complications, intraocular lens biomaterial and design, and host reaction to the lens. The factor indicating the biocompatibility of an intraocular lens is the behavior of inflammatory and lens epithelial cells. Hence, the biocompatibility of intraocular lens materials is assessed in terms of uveal biocompatibility, based on the inflammatory foreign-body reaction of the eye against the implant, and in terms of capsular biocompatibility, determined by the relationship of the intraocular lens with residual lens epithelial cells within the capsular bag. Insufficient biocompatibility of intraocular lens materials may result in different clinical entities such as anterior capsule opacification, posterior capsule opacification, and lens epithelial cell ongrowth. Intraocular lenses are increasingly implanted much earlier in life in cases such as refractive lens exchange or pediatric intraocular lens implantation after congenital cataract surgery, and these lenses are expected to exhibit maximum performance for many decades. The materials used in intraocular lens manufacture should, therefore, ensure long-term uveal and capsular biocompatibility. In this article, we review the currently available materials used in the manufacture of intraocular lenses, especially with regard to their uveal and capsular biocompatibility, and discuss efforts to improve the biocompatibility of intraocular lenses.
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Affiliation(s)
- Pelin Özyol
- Muğla Sıtkı Koçman University Training and Research Hospital, Department of Ophthalmology, Muğla, Turkey
| | - Erhan Özyol
- Muğla Sıtkı Koçman University Training and Research Hospital, Department of Ophthalmology, Muğla, Turkey
| | - Fatih Karel
- Dünyagöz Hospital, Ophthalmology Clinic, Ankara, Turkey
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Hedayatfar A, Hashemi H, Asghari S, Badie N, Miraftab M. Chronic subclinical inflammation after phakic intraocular lenses implantation: Comparison between Artisan and Artiflex models. J Curr Ophthalmol 2017; 29:300-304. [PMID: 29270478 PMCID: PMC5735246 DOI: 10.1016/j.joco.2017.06.003] [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: 03/06/2017] [Revised: 05/29/2017] [Accepted: 06/13/2017] [Indexed: 11/11/2022] Open
Abstract
Purpose To compare chronic subclinical inflammation induced after implantation of Artisan vs. Artiflex phakic intraocular lenses (pIOLs). Methods This prospective, comparative, non-randomized study included consecutive patients with moderate to high myopia who underwent Artisan or Artiflex pIOL implantation with standard surgery and postoperative care. Anterior chamber flare was assessed quantitatively using laser flare photometry (LFP) at baseline, 1 week, 1 month, 3 months, 6 months, and 2 years after surgery. Results PIOLs were implanted in 72 eyes (40 patients); Artisan pIOLs in 16 eyes (Artisan group) and Artiflex pIOLs in 56 eyes (Artiflex group). The mean preoperative anterior chamber flare was 6.5 ± 2.3 (range, 4.2–9.5) photons per millisecond (ph/ms) and 4.2 ± 0.9 (range, 2.5–11.7) ph/ms in Artisan and Artiflex groups, respectively (P = 0.400). In spite of early postoperative rise, the flare value returned to preoperative levels 6 months after pIOL implantation and remained stable up to 2 years. The amount of flare was not statistically different between Artisan and Artiflex groups in any postoperative follow-up (all P > 0.05). The trend in flare changes was not different between the studied groups (ANCOVA, P = 0.815). Conclusion The inflammatory response induced by implantation of either type of Artisan and Artiflex pIOLs is short-lived without statistically significant difference between the two models.
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Affiliation(s)
- Alireza Hedayatfar
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.,Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Soheila Asghari
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Badie
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
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Keles S, Ondas O, Ates O, Ekinci M, Kartal B, Arpali E, Yildirim K, Ceylan E, Baykal O. Phacoemulsification and Core Vitrectomy in Fuchs' Heterochromic Uveitis. Eurasian J Med 2017. [PMID: 28638250 DOI: 10.5152/eurasianjmed.2017.17026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the efficacy of phacoemulsification combined with posterior capsulorhexis, core vitrectomy and ciliary sulcus intraocular lens (IOL) implantation in patients with Fuchs' heterochromic uveitis (FHU). MATERIALS AND METHODS A total of 18 eyes of 18 patients with FHU underwent cataract surgery were included in the study. 18 eyes with FHU underwent posterior capsulorhexis, core vitrectomy and poly (methyl methacrylate) (PMMA) IOL implantation in the ciliary sulcus. Subjects were chosen for this procedure based on an intraoperative vitreous haziness assessment, performed by indirect ophthalmoscopy. Patients with +2 or more vitreous haziness qualified for this procedure. RESULTS Of the 83 eyes with FHU that underwent cataract surgery, 18 eyes (21.6%) of 18 patients were employed in the study. There were 11 (61.1%) men and 7 (38.9%) women in the study; ages ranged from 23 to 47, with a mean of 32.06 years. Follow-up ranged from 8 months to 49 months. There were no intraoperative complications except for peripheral iris bleeding in 7 eyes. There was no severe intraocular inflammation in any patient postoperatively. All patients had 0.05 or better logMAR visual acuity after corneal suture removal. Glaucoma developed in 2 patients. For the short term period, the main vision threatening problem was suture-induced astigmatism. CONCLUSION Cataract surgery combined with posterior capsulorhexis, core vitrectomy and IOL implantation in the ciliary sulcus is safe and leads to good visual outcome due to the removal of the hazy vitreous in patients with FHU.
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Affiliation(s)
- Sadullah Keles
- Department of Ophthalmology, Atatürk University School of Medicine, Erzurum, Turkey
| | - Osman Ondas
- Department of Ophthalmology, Atatürk University School of Medicine, Erzurum, Turkey
| | - Orhan Ates
- Department of Ophthalmology, Atatürk University School of Medicine, Erzurum, Turkey
| | - Metin Ekinci
- Department of Ophthalmology, Medical Park Hospital, Kocaeli, Turkey
| | - Baki Kartal
- Department of Ophthalmology, Buhara Hospital, Erzurum, Turkey
| | - Eren Arpali
- Department of Ophthalmology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Kenan Yildirim
- Department of Ophthalmology, Igdır State Hospital, Iğdır, Turkey
| | - Erdinc Ceylan
- Department of Ophthalmology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Orhan Baykal
- Department of Ophthalmology, Atatürk University School of Medicine, Erzurum, Turkey
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Postoperative occlusion of visual axis with fibrous membrane in the presence of anterior capsular phimosis in a patient with pseudoexfoliation syndrome: a case report. BMC Ophthalmol 2016; 16:213. [PMID: 27923362 PMCID: PMC5142273 DOI: 10.1186/s12886-016-0394-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 11/25/2016] [Indexed: 11/27/2022] Open
Abstract
Background To report a case of postoperative fibrous membrane formation occluding the visual axis in the presence of anterior capsular phimosis in a patient with pseudoexfoliation syndrome. Case presentation A 79-year-old Asian woman with pseudoexfoliation syndrome underwent uneventful phacoemulsification and implantation of one-piece hydrophilic acrylic square-edged intraocular lens (Cristalens) in the right eye. Two months later, she had blurred vision in the right eye with the best-corrected visual acuity (BCVA) of 20/40. Formation of fibrous membrane occluding the capsulorhexis opening with contraction of anterior capsule was observed, which was confirmed by anterior segment optical coherence tomography. Clear visual axis was achieved by lysis of the membrane using Nd:YAG laser. The BCVA improved to 20/20. Conclusions Occlusion of the visual axis with fibrous membrane can develop in the presence of anterior capsular phimosis in a patient with pseudoexfoliation syndrome.
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Uveale und kapsuläre Biokompatibilität unterschiedlicher Intraokularlinsen bei unterschiedlichen Ausgangssituationen. SPEKTRUM DER AUGENHEILKUNDE 2016. [DOI: 10.1007/s00717-016-0305-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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25
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Todorich B, Thanos A, Yonekawa Y, Thomas BJ, Abbey AM, Faia LJ. Transconjunctival Sutureless Intrascleral Fixation of Secondary Intraocular Lenses in Patients with Uveitis. Ocul Immunol Inflamm 2016; 26:456-460. [DOI: 10.1080/09273948.2016.1231328] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Bozho Todorich
- Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA
| | - Aristomenis Thanos
- Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA
| | - Yoshihiro Yonekawa
- Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA
| | - Benjamin J. Thomas
- Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA
| | | | - Lisa J. Faia
- Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA
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Phatak S, Lowder C, Pavesio C. Controversies in intraocular lens implantation in pediatric uveitis. J Ophthalmic Inflamm Infect 2016; 6:12. [PMID: 27009616 PMCID: PMC4805676 DOI: 10.1186/s12348-016-0079-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 03/13/2016] [Indexed: 11/10/2022] Open
Abstract
Cataract is one of the most common and visually debilitating complications of pediatric uveitis. It develops as a consequence of chronic inflammation and steroid use and is seen most often in juvenile idiopathic arthritis (JIA)-associated uveitis. Cataract extraction with intraocular lens (IOL) insertion has been carried out with a measure of success in non-uveitic pediatric eyes, but in cases of uveitis, multiple factors affect the final outcome. Chronic inflammation and its sequelae such as band keratopathy, posterior synechiae, and cyclitic membranes make surgical intervention more challenging and outcome less certain. Postoperative complications like increased inflammation, glaucoma, posterior capsular opacification, retrolental membranes, and hypotony may compromise the visual outcome. Early refractive correction is imperative in pediatric eyes to prevent amblyopia. The use of contact lenses and intraocular lenses in pediatric uveitic eyes were fraught with complications in the past. Surgical interventions such as vitreo-lensectomy followed by contact lens fitting and small incision cataract surgery followed by different types of intraocular lenses have been utilized, and many reports have been published, albeit in small patient groups. This review analyzes and discusses the existing literature on intraocular lens implantation in cases of pediatric uveitic cataract surgery.
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Affiliation(s)
- Sumita Phatak
- Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK.
| | - Careen Lowder
- Cleveland Clinic Cole Eye Institute, 9500 Euclid Ave, Cleveland, OH, 44106, USA
| | - Carlos Pavesio
- Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK.,Inflammation and Immunotherapy Theme, National Institute for Health Research (NIHR) Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, 162 City Road, London, EC1V 2PD, UK
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27
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Chang P, Lin L, Zheng Q, Yu F, Yu X, Zhao Y, Ding X, Zhu W, Li J, Zhao YE. An Optical Section-Assisted In Vivo Rabbit Model for Capsular Bend and Posterior Capsule Opacification Investigation. PLoS One 2016; 11:e0148553. [PMID: 26840405 PMCID: PMC4739694 DOI: 10.1371/journal.pone.0148553] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 01/20/2016] [Indexed: 12/02/2022] Open
Abstract
Purpose To establish an optical section-assisted in vivo rabbit model for capsular bend and posterior capsule opacification (PCO) investigation. Methods A total of 10 rabbits underwent phacoemulsification surgery and intraocular lens (IOL) implantation. On the basis of the relationship between the anterior capsule and IOL, the rabbits were divided into complete overlap and incomplete overlap groups, in which six and four rabbits were included, respectively. The capsular bend optical sections were assessed using ultra-long scan depth optical coherence tomography (UL-OCT), and posterior capsule opacification was evaluated with slit lamp on postoperative day 3, 7, 14, and 28. In addition, histopathological section was used to verify the accuracy of capsular bend type captured by OCT in three rabbits. Results Based on the special animal model, six capsular bend types were observed, namely, anterior (A), middle (M), posterior (P), detachment (D), funnel (Fun) and furcate adhesion (Fur). On day 3, capsular bend began to form. On 14 days, the capsular bends were comprised of A, M and D types, which were almost maintained until day 28. Histopathological section findings were consistent with optical sectioning results. In the incomplete and complete groups, the earliest PCO within the optical zone were on day 7 and 28, respectively. The incomplete group exhibited higher incidence and faster PCO on day 7 (p = 0.038) and 14 (p = 0.002). Conclusions This animal model not only mimics capsular bend evolution and PCO processes but also produces OCT optical section images equivalent to and more repeatable than histopathology, thereby providing a promising method for the further investigations of PCO.
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Affiliation(s)
- Pingjun Chang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lei Lin
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qian Zheng
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fang Yu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaoyu Yu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yinying Zhao
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xixia Ding
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weigen Zhu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jin Li
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- * E-mail: ; (YEZ); (JL)
| | - Yun-e Zhao
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- * E-mail: ; (YEZ); (JL)
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Duman R, Karel F, Özyol P, Ateş C. Effect of four different intraocular lenses on posterior capsule opacification. Int J Ophthalmol 2015; 8:118-21. [PMID: 25709920 PMCID: PMC4325254 DOI: 10.3980/j.issn.2222-3959.2015.01.22] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 03/14/2014] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate the impact of 4 different intraocular lenses (IOLs) on posterior capsule opacification (PCO) by comparing the neodymium: yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy rates. METHODS This retrospective study included 4970 eyes of 4013 cataract patients who underwent phacoemulsification and IOL implantation between January 2000 and January 2008 by the same surgeon at one clinic. Four different IOLs were assessed. The outcome parameter was the incidence of Nd:YAG laser posterior capsulotomies. RESULTS An Nd:YAG laser posterior capsulotomy was performed in 153 (3.07%) of the 4970 eyes. The mean follow-up time was 84mo for all of the IOL groups. The percentage of eyes developing PCO was significantly greater for the acrylic hydrophilic IOLs than for the hydrophobic IOLs, although eyes with acrylic hydrophilic IOLs did not require Nd:YAG laser capsulotomy as soon as eyes with acrylic hydrophobic IOLs. There was no difference between the long-term PCO rates when 1- and 3-piece acrylic hydrophobic IOLs were compared or when IOLs made of the same material but with different haptic angles were compared. CONCLUSION In this study, eyes with acrylic hydrophilic IOLs were more likely to develop PCO than those with acrylic hydrophobic IOLs. The lens design (1-piece versus 3-piece and varying haptic angles) did not affect the PCO rate.
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Affiliation(s)
- Rahmi Duman
- Department of Ophthalmology, Ankara Oncology Hospital, Ankara 06200, Turkey
| | - Fatih Karel
- Department of Ophthalmology, Dünya Göz Hospital Group, Ankara 06680, Turkey
| | - Pelin Özyol
- Department of Ophthalmology, Ünye State Hospital, Ordu 52300, Turkey
| | - Can Ateş
- Department of Biostatistics, Ankara University School of Medicine, Ankara 06100, Turkey
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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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Pintwala R, Postnikoff C, Molladavoodi S, Gorbet M. Coculture with intraocular lens material-activated macrophages induces an inflammatory phenotype in lens epithelial cells. J Biomater Appl 2014; 29:1119-32. [PMID: 25281645 DOI: 10.1177/0885328214552711] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cataracts are the leading cause of blindness worldwide, requiring surgical implantation of an intraocular lens. Despite evidence of leukocyte ingress into the postoperative lens, few studies have investigated the leukocyte response to intraocular lens materials. A novel coculture model was developed to examine macrophage activation by hydrophilic acrylic (poly(2-hydroxyethyl methacrylate)) and hydrophobic acrylic (polymethylmethacrylate) commercial intraocular lens. The human monocytic cell line THP-1 was differentiated into macrophages and cocultured with human lens epithelial cell line (HLE-B3) with or without an intraocular lens for one, two, four, or six days. Using flow cytometry and confocal microscopy, expression of the macrophage activation marker CD54 (intercellular adhesion molecule-1) and production of reactive oxygen species via the fluorogenic probe 2',7'-dichlorodihydrofluorescein diacetate were examined in macrophages. α-Smooth muscle actin, a transdifferentiation marker, was characterized in lens epithelial cells. The poly(2-hydroxyethyl methacrylate) intraocular lens prevented adhesion but induced significant macrophage activation (p < 0.03) versus control (no intraocular lens), while the polymethylmethacrylate intraocular lens enabled adhesion and multinucleated fusion, but induced no significant activation. Coculture with either intraocular lens increased reactive oxygen species production in macrophages after one day (p < 0.03) and increased expression of α-smooth muscle actin in HLE B-3 after six days, although only poly(2-hydroxyethyl methacrylate) induced a significant difference versus control (p < 0.01). Our results imply that-contrary to prior uveal biocompatibility understanding-macrophage adherence is not necessary for a strong inflammatory response to an intraocular lens, with hydrophilic surfaces inducing higher activation than hydrophobic surfaces. These findings provide a new method of inquiry into uveal biocompatibility, specifically through the quantification of cell-surface markers of leukocyte activation.
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Affiliation(s)
- Robert Pintwala
- Faculty of Engineering, Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Cameron Postnikoff
- Faculty of Engineering, Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Sara Molladavoodi
- Faculty of Engineering, Department of Mechanical Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Maud Gorbet
- Faculty of Engineering, Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
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Cataract extraction surgery in patients with uveitis in Taiwan: Risk factors and outcomes. J Formos Med Assoc 2014; 113:377-84. [DOI: 10.1016/j.jfma.2013.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 08/16/2013] [Accepted: 10/04/2013] [Indexed: 11/23/2022] Open
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McCanna DJ, Barthod-Malat AV, Gorbet MB. In vitro methods of assessing ocular biocompatibility using THP-1-derived macrophages. Cutan Ocul Toxicol 2014; 34:89-100. [PMID: 24738714 DOI: 10.3109/15569527.2014.908205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Macrophages play an important role in the elimination of infections, the removal of debris and in tissue repair after infection and trauma. In vitro models that assess ocular biomaterials for toxicity typically focus on the effects of these materials on epithelial or fibroblast cells. This investigation evaluated known ocular toxins deposited on model materials for their effects on the viability and activation of macrophages. THP-1-derived macrophages were cultured onto silicone films (used as a base biomaterial) deposited with chemical toxins (benzalkonium chloride (BAK), zinc diethyldithiocarbamate (ZDEC) and lipopolysaccharide (LPS)). Utilizing three fluorescent dyes calcein, ethidium homodimer-1 (EthD-1) and annexin V, the viability of macrophages attached to the biomaterial was determined using confocal microscopy. Propidium iodide (PI) staining and alamarBlue® (resazurin) reduction were used to assess cell death and metabolic activity. CD14, CD16, CD33, CD45, and CD54 expression of adherent macrophages, were also evaluated to detect LPS activation of macrophages using flow cytometry. The sensitivity of this test battery was demonstrated as significant toxicity from treated surfaces with ZDEC (0.001-0.01%), and BAK (0.001%-0.1%) was detected. Also, macrophage activation could be detected by measuring CD54 expression after exposure to adsorbed LPS. These in vitro methods will be helpful in determining the toxicity potential of new ocular biomaterials.
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Affiliation(s)
- David Joseph McCanna
- School of Optometry and Vision Science, Centre for Contact Lens Research, University of Waterloo , Waterloo, Ontario , Canada and
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Abstract
BACKGROUND Cataract formation often occurs in people with uveitis. It is unclear which intraocular lens (IOL) type is optimal for use in cataract surgery for eyes with uveitis. OBJECTIVES To summarize the effects of different IOLs on visual acuity, other visual outcomes, and quality of life in people with uveitis. SEARCH METHODS We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 7), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to August 2013), EMBASE (January 1980 to August 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to August 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 14 August 2013. We also performed forward and backward searching using the Science Citation Index and the reference lists of the included studies, respectively, in August 2013. SELECTION CRITERIA We included randomized controlled trials (RCTs) comparing hydrophobic or hydrophilic acrylic, silicone, or poly(methyl methacrylate) (PMMA) IOLs with or without heparin-surface modification (HSM), with each other, or with no treatment in adults with uveitis, for any indication, undergoing cataract surgery. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by The Cochrane Collaboration. Two review authors screened the search results and for included studies, assessed the risk of bias and extracted data independently. We contacted study investigators for additional information. We did not perform a meta-analysis due to variability in reporting and follow-up intervals for the primary and secondary outcomes of interest. MAIN RESULTS We included four RCTs involving 216 participants (range of 2 to 140 participants with uveitic cataract per trial) and comparing up to four types of IOLs. The largest study was an international study with centers in Brazil, Egypt, Finland, France, Japan, the Netherlands, Slovak Republic, Spain, and the USA; two studies were conducted in Germany and one in Saudi Arabia. There was substantial heterogeneity with respect to the ages of participants and etiologies of uveitis within and across studies. The length of follow-up among the studies ranged from 1 to 24 months after cataract surgery. The studies were at low risk of selection bias, but two of the four studies did not employ masking and only one study included all randomized participants in the final analyses. The funding source was disclosed by investigators of the largest study (professional society) and not reported by the other three. Due to heterogeneity in lens types evaluated and outcomes reported among the trials, we did not combine data in a meta-analysis.In the largest study (140 participants), the study eye of each participant was randomized to receive one of four types of IOLs: hydrophobic acrylic, silicone, HSM PMMA, or unmodified PMMA. Proportions of participants with one or more Snellen lines of visual improvement were similar among the four treatment groups at one year' follow-up: 45 of 48 (94%) in the hydrophobic acrylic IOL group, 39 of 44 (89%) in the silicone IOL group, 18 of 22 (82%) in the HSM PMMA IOL group, and 22 of 26 (85%) in the unmodified PMMA IOL group. When comparing hydrophobic acrylic IOLs with silicone IOLs, the risk ratio (RR) was 1.06 (95% confidence interval (CI) 0.93 to 1.20). At one year' follow-up, fewer eyes randomized to hydrophobic acrylic IOLs developed posterior synechiae when compared with eyes receiving silicone IOLs (RR 0.18, 95% CI 0.04 to 0.79); the effects between these groups were less certain with respect to developing posterior capsule opacification (PCO) (RR 0.74, 95% CI 0.41 to 1.37), corneal edema (RR 0.49, 95% CI 0.22 to 1.12), cystoid macular edema (RR 0.10, 95% CI 0.01 to 1.84), or mild IOL decentration (RR 0.92, 95% CI 0.06 to 14.22).Two intra-individual studies also compared HSM PMMA IOLs with unmodified PMMA IOLs at three or six months of follow-up. These studies, including a combined total of 16 participants with uveitis, were insufficiently powered to detect differences in outcomes among eyes of people with uveitis randomized to receive HSM PMMA IOLs when compared with fellow eyes receiving unmodified PMMA IOLs.In the fourth study (60 participants), the study eye of each participant was randomized to receive a hydrophobic or hydrophilic acrylic IOL. At three months, there were no statistical or clinical differences between hydrophobic and hydrophilic acrylic IOL types in the proportions of participants with two or more Snellen lines of visual improvement (RR 1.03, 95% CI 0.87 to 1.22). There were similar rates in the development of PCO between hydrophobic or hydrophilic acrylic IOLs at six months' follow-up (RR 1.00, 95% CI 0.80 to 1.25). The effect of the lenses on posterior synechiae was uncertain at six months' follow-up (RR 0.50, 95% CI 0.05 to 5.22).None of the included studies reported quality of life outcomes. AUTHORS' CONCLUSIONS Based on the trials identified in this review, there is uncertainty as to which type of IOL provides the best visual and clinical outcomes in people with uveitis undergoing cataract surgery. The studies were small, not all lens materials were compared in all studies, and not all lens materials were available in all study sites. Evidence of a superior effect of hydrophobic acrylic lenses over silicone lenses, specifically for posterior synechiae outcomes comes from a single study at a high risk of performance and detection bias. However, due to small sample sizes and heterogeneity in outcome reporting, we found insufficient information to assess these and other types of IOL materials for cataract surgery for eyes with uveitis.
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Affiliation(s)
- Theresa G Leung
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kristina Lindsley
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Irene C Kuo
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Mylonas G, Georgopoulos M, Prinz A, Vock L, Blum RA, Schmidt-Erfurth U. Influence of a variable overall diameter hydrophilic acrylic sharp-edged single-piece intra-ocular lens on capsule opacification one year after surgery. Curr Eye Res 2014; 39:620-5. [PMID: 24400639 DOI: 10.3109/02713683.2013.863939] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND To investigate the influence of the overall intraocular lens (IOL) diameter on posterior capsule opacification (PCO) formation. METHODS In this prospective randomized clinical trial, 124 eyes of 62 patients with bilateral age-related cataract were included. Each patient received a Corneal A501D IOL in one eye and a Corneal J501D IOL in the fellow eye. Best corrected visual acuity (BCVA) and digital slitlamp photographs were taken a 1 h, 1 week, 1, 3, 6 and 12 months postoperatively. The amount of PCO was assessed subjectively at the slitlamp and objectively using automated image-analysis software. RESULTS We found a mean BCVA of 0.81 ± 0.2 for the Corneal A501D group and 0.79 ± 0.21 for the Corneal J501D group. There was no significant difference 12 months after surgery between the two IOLs (p > 0.05). Objective PCO assessment resulted in a mean PCO score (scale 0-10) of 1.65 ± 1.71 was found for the Corneal J501D group and a score of 1.54 ± 1.64 was found for the Corneal A501D group (p > 0.05). The subjective PCO assessment at 1 year resulted in a mean PCO score of 2.0 ± 1.74 in the Corneal J501D group and 2.13 ± 1.64 in the Corneal A501D group (p > 0.05). CONCLUSION Both investigated IOLs showed good clinical performance regarding PCO and BCVA. Our study suggests that the use of an IOL with variable total diameter seems not to influence the rate of PCO formation.
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Affiliation(s)
- Georgios Mylonas
- Department of Ophthalmology, Medical University of Vienna , Vienna , Austria
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Li Y, Wang J, Chen Z, Tang X. Effect of hydrophobic acrylic versus hydrophilic acrylic intraocular lens on posterior capsule opacification: meta-analysis. PLoS One 2013; 8:e77864. [PMID: 24223736 PMCID: PMC3818402 DOI: 10.1371/journal.pone.0077864] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 09/13/2013] [Indexed: 11/19/2022] Open
Abstract
PURPOSE This meta-analysis aims to evaluate the differences in performance of posterior capsular opacification (PCO) between hydrophobic acrylic intraocular lens (IOLs) and hydrophilic acrylic IOLs. SETTING Tianjin Medical University, Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin, China. DESIGN Systematic review of randomized controlled trials (RCTs) or meta-analysis. METHODS An electronic literature search was performed using the PubMed, EMBASE and Cochrane Library database before May in 2013 to identify prospective RCTs comparing hydrophobic acrylic IOLs and hydrophilic acrylic IOLs in patients after phacoemulsification with IOL implantation with a follow-up time of at least 1 year. Pertinent studies were selected by meeting predefined criteria and reviewed systematically by meta-analysis. The PCO scores and YAG capsulotomy rate, as indicator of PCO, were measured and discussed in a meta-analysis. Standardized mean differences (SMD), relative risk ratio (RR), and the pooled estimates were computed according to a random effect model or fixed effect model. RESULTS Nine prospective RCTs involving 861 eyes were included in the current meta-analysis. The hydrophobic acrylic IOLs were favored and the pooled SMD of PCO severity was 1.72 (95% confidence interval (CI), 0.20 to 1.23, P = 0.0002) and 1.79 (95% CI, 0.95 to 2.64, P<0.0001) with 1-year follow-up and 2-year follow-up respectively. The pooled RR of Nd:YAG laser capsulotomy rates at postoperative 2-year follow-up was 6.96 (95% CI, 3.69 to 13.11, P<0.00001) comparing hydrophilic acrylic IOLs with hydrophobic acrylic IOLs. CONCLUSIONS Compared with hydrophilic acrylic IOLs, the hydrophobic acrylic IOLs showed superior reduction in rates of PCO and laser capsulotomy in 2-year follow-up. More RCTs with standard methods for longer follow-up are needed to validate the association.
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Affiliation(s)
- Ying Li
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Eye Hospital, Tianjin, China
| | - Jiaxing Wang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhuo Chen
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Eye Hospital, Tianjin, China
| | - Xin Tang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Eye Hospital, Tianjin, China
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Lee H, Oh HJ, Yoon KC, Tae G, Kim YH. Fast in situ enzymatic gelation of PPO-PEO block copolymer for injectable intraocular lens in vivo. J Biomater Appl 2013; 28:1247-63. [DOI: 10.1177/0885328213505247] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Foldable intraocular lenses (IOLs) have been utilized to substitute natural lens of cataract patients. In this study, we developed a fast, in situ gelable hydrogel requiring no toxic agent as an injectable IOL material. A 4-armed PPO/PEO-phenol conjugate by a non-degradable linker was synthesized to form a hydrogel in situ by horseradish peroxidase. The gelation time and modulus could be controlled, ranging from 20 s to 2 min and from 1 to 43 kPa. The adhesion of human lens epithelial cells on the hydrogel was significantly reduced compared to that on commercial IOLs. The hydrogels were injected into the rabbit eyes to evaluate the in vivo biocompatibility for 8 weeks. Corneal endothelial cell loss and central corneal thickness were comparable with the common IOL implantation procedure. Histologically, the cornea and retina showed the intact structure. The change of refraction after application of pilocarpine was +0.42 D preoperatively and +0.83 D postoperatively, which may indicate the maintenance of accommodation amplitude.
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Affiliation(s)
- Hanna Lee
- School of Materials Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Korea
| | - Han Jin Oh
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Kyung Chul Yoon
- Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Giyoong Tae
- School of Materials Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Korea
| | - Young Ha Kim
- Department of Medical System Engineering, Gwangju Institute of Science and Technology, Oryong-dong, Buk-gu, Gwangju, 500-712, Korea
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Abstract
Cataract surgery in patients with uveitis is not as simple as any senile cataract surgery. Recent evidence suggests that useful visual outcome can be achieved in most of the cases if they are handled meticulously. Key factors leading to improved visual outcome are absolute control of preoperative inflammation with diligent use of immunomodulatory drugs, meticulous surgery along with early detection and care of postoperative complications. Modern technologies in the intraocular lens designs and materials have contributed to the success. In this article, we review the literature on this subject with emphasis on the importance of the use of immunomodulatory drugs to control preoperative and postoperative intraocular inflammation and avoid complications.
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Kleinmann G, Zaugg B, Apple DJ, Bleik J. Pediatric cataract surgery with hydrophilic acrylic intraocular lens. J AAPOS 2013; 17:367-70. [PMID: 23928003 DOI: 10.1016/j.jaapos.2013.04.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Revised: 03/23/2013] [Accepted: 04/02/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To assess the outcomes after hydrophilic acrylic intraocular lens (IOL) implantation during pediatric cataract surgery. METHODS This was a retrospective chart review of children who underwent cataract surgery or secondary IOL implantation at Beirut Eye Specialist Centre, Rizk Hospital, between March 2002 and August 2007. RESULTS A total of 57 eyes of 40 patients (20 boys) were included in this study. The average age at surgery was 48 ± 40 months (range, 5-172 months). Of these, 54 eyes had congenital or developmental cataracts and 3 eyes had traumatic cataracts. Primary cataract removal and IOL implantation accounted for 45 surgeries, and secondary IOL implantation accounted for 12 surgeries. Hydrophilic acrylic IOLs were implanted in all surgeries. Average follow-up time was 47 ± 21 months (range, 9-97 months). No intraoperative complications were recorded. Of the 57 eyes, 12 (21%) had postoperative complications, but only 7 (12%) required secondary intervention. Average best-corrected visual acuity improved from 2.0 ± 1.0 logMAR preoperatively to 0.8 ± 1.0 logMAR at last follow-up. Improved visual acuity was observed in 47 eyes (82.5%); 31 eyes (54.4%) had a visual acuity of ≥ 20/40 at the last follow-up. CONCLUSIONS Hydrophilic acrylic IOLs appear to be suitable for use in pediatric cataract surgery. Results from this study suggest that, compared with hydrophobic IOLs, these IOLs produce similar complication rates, secondary intervention rates, and visual acuity results.
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Affiliation(s)
- Guy Kleinmann
- John A. Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, Utah.
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Yoo YS, Yang JW, Lee YC, Kim SY. Incidence and Risk Factors of Nd:YAG Capsulotomy in Adult Cataract Patients Younger than 50 Years of Age. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.9.1339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Young Sik Yoo
- Department of Ophthalmology & Visual Science College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Wook Yang
- Department of Ophthalmology & Visual Science College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Chun Lee
- Department of Ophthalmology & Visual Science College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Su Young Kim
- Department of Ophthalmology & Visual Science College of Medicine, The Catholic University of Korea, Seoul, Korea
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Abstract
PURPOSE OF REVIEW To describe the epidemiology, pathogenesis, and recent developments in the diagnosis and management of postcataract surgery inflammation. RECENT FINDINGS In patients with pre-existing uveitis, control of inflammation with topical and/or systemic therapy for 3 months preoperatively continues to be important in lessening the risk of postoperative inflammation and complications. During cataract surgery, intraocular lens selection in these patients is important. Recent literature suggests that modern intraocular lenses (IOLs), particularly hydrophilic or hydrophobic acrylic lenses, generally have good uveal biocompatibility in uveitic patients. The postoperative course can be complicated by inflammation and cystoid macular edema (CME), and in uveitic patients, intensive perioperative steroid treatment can lessen these complications. Recent studies show that in uveitic patients, the improvement in CME and inflammation after intravitreal triamcinolone is better than after orbital floor triamcinolone injection, but that a single intraoperative orbital floor injection of triamcinolone is as effective as a 4-week course of postoperative oral prednisolone. Although postoperative inflammation in uveitic patients may be due to recurrence of uveitis, one must recognize other important potential causes of postoperative inflammation and treat accordingly. SUMMARY Most patients with postcataract inflammation have good visual outcomes provided that the cause is recognized and that there is adequate perioperative planning in patients predisposed to inflammation.
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González-Guijarro JJ, Tamés Haye I, Valdivia Pérez A. [Phacoemulsification and acrylic intraocular lens in uveitis: a comparative study]. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2012; 87:9-16. [PMID: 22248652 DOI: 10.1016/j.oftal.2011.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Revised: 03/24/2011] [Accepted: 06/29/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To describe the outcomes of phacoemulsification with the implant of an acrylic intraocular lens (IOL) in cataracts of adult patients with and without uveitis METHODS Descriptive retrospective comparative study of 35 patients (45 eyes) with uveitis (group 1) and 38 (44 eyes) control patients (group 2), who were operated on by the same surgeon, and were homogeneous as regards sex, surgical technique, IOL (hydrophobic or hydrophilic) and follow-up. The pre-surgical characteristics of risk, the difficulties and intra-surgical and postsurgical complications, the date of posterior capsulotomy (PC) and the pre- and post-surgical visual acuity (VA), were analysed. RESULTS In both groups the coaxial phacoemulsification was used in 75% of the eyes, bimanual microincision cataract surgery (MICS) in 20% and micro-coaxial in the rest. The pre-surgical risk factors (P = .002, OR 6.83), the surgical difficulties and complications (P = .001, OR 7.54) and postsurgical complications (P = .069, OR 3.42) were more frequent in the uveitis group. In both 93% and 91% respectively of eyes improved 2 or more lines of VA. After an average follow-up of 4.9 years in both groups, 22.7% and 32% eyes (log-rank P = .357) needed PC. The hydrophilic IOLs needed PC earlier than the hydrophobic ones (log rank P = .001), neither the location nor the uveitis course influenced the PC rate. CONCLUSIONS The consequences because of previous ocular inflammation make cataract surgery in uveitis more difficult, but with postsurgical complications, visual results and need of PC similar to our patients without inflammation.
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Hydrophilic acrylic intraocular lens optic opacification in a diabetic patient. Jpn J Ophthalmol 2011; 55:595-9. [DOI: 10.1007/s10384-011-0074-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 06/15/2011] [Indexed: 10/17/2022]
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Stock G, Ahlers C, Dunavoelgyi R, Kahraman G, Schauersberger J, Schmidt-Erfurth U, Amon M. Evaluation of anterior-segment inflammation and retinal thickness change following cataract surgery. Acta Ophthalmol 2011; 89:369-75. [PMID: 19878107 DOI: 10.1111/j.1755-3768.2009.01704.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To investigate the physiological retinal response to uneventful cataract surgery using conventional time-domain (TD-OCT) and current spectral-domain optical coherence tomography (SD-OCT) in combination with an assessment of the anterior chamber inflammatory reaction by laser flare/cell meter (LCFM). METHODS Thirty-four patients scheduled for cataract surgery were included in this prospective pilot study. Retinal parameters were examined according to a standardized examination procedure using TD-OCT (Stratus; Carl Zeiss Meditec, Dublin, California, USA) and SD-OCT (Cirrus; Carl Zeiss Meditec) devices. The inflammatory reaction of the anterior chamber was measured by LFCM (Kowa FC-1000, Kowa Co. Ltd, Tokyo, Japan). Examinations were carried out preoperatively and at day 2, week 1 and week 4 postoperatively. RESULTS A slight decrease of central retinal thickness values was identified at day 2 postoperatively followed by an increase of these parameters at week 4. LFCM showed peak values in all patients at day 2 postoperatively with a constant decrease at the following visits. No visible pathological retinal changes were seen after surgery. CONCLUSION A biphasic retinal response after surgery could be shown with SD-OCT and TD-OCT technology. By using the advantages of rasterscanning mode, SD-OCT technology is superior to TD-OCT imaging in the investigation of the physiological retinal response to cataract surgery.
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Affiliation(s)
- Geraldine Stock
- Department of Ophthalmology, Medical University Vienna, Austria
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Hydrophobic versus double-square-edged hydrophilic foldable acrylic intraocular lens: Effect on posterior capsule opacification. J Cataract Refract Surg 2011; 37:1060-8. [DOI: 10.1016/j.jcrs.2010.12.059] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 12/18/2010] [Accepted: 12/29/2010] [Indexed: 11/20/2022]
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Rahman R, Briffa BV, Gupta A, Chinn DJ. Factors contributing to posterior capsule opacification following 23-gauge transconjunctival phacovitrectomy. Ophthalmic Surg Lasers Imaging Retina 2011; 42:229-33. [PMID: 21563746 DOI: 10.3928/15428877-20110420-02] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Accepted: 03/02/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To determine posterior capsule opacification (PCO) rate and identify contributory factors in a series of patients undergoing combined 23-gauge transconjunctival phacovitrectomy. PATIENTS AND METHODS Retrospective data on 221 consecutive patients operated on by a single senior surgeon using a standard technique were collected and subjected to univariate analysis with chi-square tests and multivariate analysis with logistic regression. RESULTS PCO developed in 46 of 221 cases (20.8%). Major risk factors were: rhegmatogenous retinal detachment (relative risk = 3.3, P = .002), axial length greater than 24.5 mm (relative risk = 2.0, P = .093), intraoperative/postoperative complications (relative risk = 3.3, P = .04), C2F6 tamponade (versus SF6/air) (relative risk = 2.8, P = .01), and postoperative posturing (relative risk = 4.1, P < .001). Multiple logistic regression analysis showed the latter two to be most important. CONCLUSION PCO rate following 23-gauge phacovitrectomy is lower than most rates reported for 20-gauge phacovitrectomy. Using shorter-acting gas tamponade and avoiding postoperative posturing may help lower PCO rates.
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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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Mathew RG, Coombes AGA. Reduction of Nd:YAG capsulotomy rates after implantation of a single-piece acrylic hydrophilic intraocular lens with 360° squared optic edge: 24-month results. Ophthalmic Surg Lasers Imaging Retina 2010; 41:651-5. [PMID: 20954645 DOI: 10.3928/15428877-20100929-04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Accepted: 07/29/2010] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Posterior capsule opacification remains a significant problem following cataract surgery. The aim of the study was to evaluate the incidence of symptomatic posterior capsule opacification requiring Nd:YAG capsulotomy in patients who underwent cataract extraction and implantation of the Rayner C-flex 570C intraocular lens (IOL) (Rayner Intraocular Lens, Ltd., Sussex, UK). PATIENTS AND METHODS A retrospective study of 3,461 eyes that underwent cataract extraction and insertion of the Rayner C-flex IOL from January 2004 to December 2005. The cases that received Nd: YAG capsulotomies were evaluated. RESULTS Over a 24-month period, 3,461 Rayner C-flex IOLs were implanted. Nd:YAG capsulotomy was performed in 58 of these cases. The rate of Nd:YAG capsulotomy was 0.6% at 12 months and 1.7% at 24 months. The mean time to Nd:YAG capsulotomy was 9.3 months (range: 1.3 to 22.7 months). The follow-up period was 5.3 to 29.0 months. CONCLUSION The incidence of symptomatic posterior capsule opacification with the Rayner C-flex IOL is low.
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Iwase T, Tanaka N. Reiterative membranous proliferation with giant-cell deposits on hydrophobic acrylic intraocular lenses after triple procedures in eyes with cataracts and uveitis. Cutan Ocul Toxicol 2010; 29:306-11. [PMID: 20854015 DOI: 10.3109/15569527.2010.511366] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To report 2 cases of reiterative membranous proliferation with giant-cell deposits on hydrophobic acrylic intraocular lenses (IOLs) after a triple procedure of vitrectomy, phacoemulsification, and IOL implantation in uveitic eyes with cataracts and vitreous opacity. METHODS A 72-year-old Japanese woman and a 67-year-old Japanese man underwent AcrySof IOL (SA60AT) implantation in their eyes (both eyes in the first case and the left eye in the second case) for the treatment of cataract and vitreous opacity with uveitis. Although intraocular inflammation seemed to be successfully controlled, the number of giant-cell deposits on the posterior surface of the posterior capsule was gradually increased with the development of posterior capsular opacification in 5 and 9 months, respectively, and neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy was required. RESULTS After the treatment, Nd:YAG laser membranotomy (4 and 5 times) was required because of repeated membranous proliferation with giant-cell deposits occurring on the posterior surface of the IOL monthly, although postoperative intraocular inflammation seemed to be controlled. CONCLUSIONS The possibility of development of this undesirable complication, which is believed to be limited in cases with hydrophobic acrylic IOL implantation, should be kept in mind. Also, Nd:YAG laser membranotomy for the proliferative membrane is an available option for recovery of vision.
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Affiliation(s)
- Takeshi Iwase
- Department of Ophthalmology, Wilmer Eye Institute, The Johns Hopkins School of Medicine, Baltimore, Maryland 21287-9277, USA
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