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Konopińska J, Młynarczyk M, Dmuchowska DA, Obuchowska I. Posterior Capsule Opacification: A Review of Experimental Studies. J Clin Med 2021; 10:jcm10132847. [PMID: 34199147 PMCID: PMC8269180 DOI: 10.3390/jcm10132847] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/13/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022] Open
Abstract
Posterior capsule opacification (PCO) is the most common complication of cataract surgery. It causes a gradual deterioration of visual acuity, which would otherwise improve after a successful procedure. Despite recent advances in ophthalmology, this complication has not been eradicated, and the incidence of PCO can be as high as 10%. This article reviews the literature concerning the pathomechanism of PCO and examines the biochemical pathways involved in its formation and methods to prevent this complication. We also review the reported tests performed in cell cultures under laboratory conditions and in experimental animal models and in ex vivo human lens capsules. Finally, we describe research involving human eyes in the clinical setting and pharmacological methods that may reduce the frequency of PCO. Due to the multifactorial etiology of PCO, in vitro studies make it possible to assess the factors contributing to its complications and search for new therapeutic targets. Not all pathways involved in cell proliferation, migration, and contraction of the lens capsule are reproducible in laboratory conditions; moreover, PCO in humans and laboratory animals may be additionally stimulated by various degrees of postoperative reactions depending on the course of surgery. Therefore, further studies are necessary.
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See GL, Arce Jr. F, Itakura S, Todo H, Sugibayashi K. Prolonged Distribution of Tranilast in the Eyes after Topical Application onto Eyelid Skin. Chem Pharm Bull (Tokyo) 2020; 68:779-783. [DOI: 10.1248/cpb.c20-00289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Gerard Lee See
- Graduate School of Pharmacy and Pharmaceutical Sciences, Josai University
- Department of Pharmacy, University of San Carlos
| | - Florencio Arce Jr.
- Graduate School of Pharmacy and Pharmaceutical Sciences, Josai University
- Department of Pharmacy, University of San Carlos
| | - Shoko Itakura
- Graduate School of Pharmacy and Pharmaceutical Sciences, Josai University
| | - Hiroaki Todo
- Graduate School of Pharmacy and Pharmaceutical Sciences, Josai University
| | - Kenji Sugibayashi
- Graduate School of Pharmacy and Pharmaceutical Sciences, Josai University
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Kim BH, Huh BK, Lee WS, Kim CR, Lee KS, Nam SY, Lee M, Heo CY, Choy YB. Silicone Implant Coated with Tranilast-Loaded Polymer in a Pattern for Fibrosis Suppression. Polymers (Basel) 2019; 11:polym11020223. [PMID: 30960207 PMCID: PMC6419080 DOI: 10.3390/polym11020223] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/25/2019] [Accepted: 01/26/2019] [Indexed: 12/17/2022] Open
Abstract
Pathologic fibrosis around silicone implants is problematic, and thus, these implants have been coated with a mixture of a biocompatible polymer and antifibrotic drug for sustained drug release to prevent fibrosis. However, a coating applied over an entire surface would be subject to mechanical instability as the implant would be severely crumpled for implant insertion. Therefore, in this work, we proposed localized, patterned coating dots, each composed of poly(lactic-co-glycolic acid) (PLGA) and tranilast, to be applied on the surface of silicone implants. The drug loaded in the pattern-coated implant herein was well retained after a cyclic tensile test. Due to the presence of PLGA in each coating dot, the tranilast could be released in a sustained manner for more than 14 days. When implanted in a subcutaneous pocket in living rats for 12 weeks, compared with the intact implant, the pattern-coated implant showed a decreased capsule thickness and collagen density, as well as less transforming growth factor-β (TGF-β) expression and fewer fibroblasts; importantly, these changes were similar between the surfaces with and without the coating dots. Therefore, we conclude that the pattern-coating strategy proposed in this study can still effectively prevent fibrosis by maintaining the physical stability of the coatings.
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Affiliation(s)
- Byung Hwi Kim
- Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul 03080, Korea.
| | - Beom Kang Huh
- Interdisciplinary Program for Bioengineering, College of Engineering, Seoul National University, Seoul 08826, Korea.
| | - Won Suk Lee
- Interdisciplinary Program for Bioengineering, College of Engineering, Seoul National University, Seoul 08826, Korea.
| | - Cho Rim Kim
- Interdisciplinary Program for Bioengineering, College of Engineering, Seoul National University, Seoul 08826, Korea.
| | - Kyu Sang Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Sun-Young Nam
- Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Miji Lee
- Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
| | - Chan Yeong Heo
- Interdisciplinary Program for Bioengineering, College of Engineering, Seoul National University, Seoul 08826, Korea.
- Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
- Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University, Seoul 03080, Korea.
| | - Young Bin Choy
- Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul 03080, Korea.
- Interdisciplinary Program for Bioengineering, College of Engineering, Seoul National University, Seoul 08826, Korea.
- Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University, Seoul 03080, Korea.
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Darakhshan S, Pour AB. Tranilast: a review of its therapeutic applications. Pharmacol Res 2014; 91:15-28. [PMID: 25447595 DOI: 10.1016/j.phrs.2014.10.009] [Citation(s) in RCA: 197] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Revised: 10/29/2014] [Accepted: 10/30/2014] [Indexed: 12/14/2022]
Abstract
Tranilast (N-[3',4'-dimethoxycinnamoyl]-anthranilic acid) is an analog of a tryptophan metabolite. Initially, tranilast was identified as an anti-allergic agent, and used in the treatment of inflammatory diseases, such as bronchial asthma, atypical dermatitis, allergic conjunctivitis, keloids and hypertrophic scars. Subsequently, the results showed that it could be also effective in the management of a wide range of conditions. The beneficial effects of tranilast have also been seen in a variety of disease states, such as fibrosis, proliferative disorders, cancer, cardiovascular problems, autoimmune disorders, ocular diseases, diabetes and renal diseases. Moreover, several trials have shown that it has very low adverse effects and it is generally well tolerated by patients. In this review, we have attempted to accurately summarize previously published studies relating to the use of tranilast for a range of disorders and discuss the drug's possible mode of action. The major mode of the drug's efficacy appears to be the suppression of the expression and/or action of the TGF-β pathway, but the drug affects other factors as well. The findings presented in this review demonstrate the potential of tranilast for the control of a vast array of pathological situations, furthermore, it is a prescribed drug without severe side effects.
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Affiliation(s)
- Sara Darakhshan
- Department of Biology, Faculty of Science, Razi University, Kermanshah, Iran
| | - Ali Bidmeshki Pour
- Department of Biology, Faculty of Science, Razi University, Kermanshah, Iran.
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Matsushima H, Iwamoto H, Mukai K, Katsuki Y, Nagata M, Senoo T. Preventing secondary cataract and anterior capsule contraction by modification of intraocular lenses. Expert Rev Med Devices 2014; 5:197-207. [DOI: 10.1586/17434440.5.2.197] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Spitzer MS, Sat M, Schramm C, Schnichels S, Schultheiss M, Yoeruek E, Dzhelebov D, Szurman P. Biocompatibility and antifibrotic effect of UV-cross-linked hyaluronate as a release-system for tranilast after trabeculectomy in a rabbit model--a pilot study. Curr Eye Res 2012; 37:463-70. [PMID: 22577763 DOI: 10.3109/02713683.2012.658593] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To analyze the release kinetics and the clinical and histological effects of UV-cross-linked hyaluronic acid as a release-system for the transforming growth factor β-2 antagonist tranilast with anti-phlogistic properties on intraocular pressure after trabeculectomy in an aggressive scarring animal model. METHODS Hyaluronate acid was UV-cross linked and loaded with tranilast. The release of tranilast into a buffered salt solution was assessed spectrophotometrically. Glaucoma filtration surgery, similar to that performed in clinical practice, was performed on chinchilla rabbits. The rabbits were divided in 3 groups. (Group A: trabeculectomy alone, group B: trabeculectomy with a cross-linked hyaluronic acid gel preparation and group C: trabeculectomy with cross-linked hyaluronic gel preparation mixed with tranilast). Antifibrotic efficacy was established by clinical response and histologic examination. RESULTS The cross-linked gels released tranilast for up to 26 h. The release plotted as a function of the square root of time was consistent with a largely diffusion-controlled release system. Both the gel preparation alone and the gel preparation mixed with tranilast were well tolerated in vivo. No adverse effects such as inflammation, corneal toxicity or blurring of the optical media were observed. The intraocular pressure reached preoperative levels within 9 days after surgery in control animals and group B, but remained significantly reduced (p = 0.00016) in the group with tranilast until day 22. CONCLUSIONS The data of this pilot study suggest that the intraoperative application of UV-crossed linked hyaluronic acid used as a slow release system for tranilast may improve the surgical outcome of glaucoma filtration surgery.
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Affiliation(s)
- Martin S Spitzer
- Centre of Ophthalmology, University Eye Hospital Tuebingen, Tuebingen, Germany
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Evereklioglu C, İlhan Ö. Do Non-Steroidal Anti-Inflammatory Drugs Delay Posterior Capsule Opacification After Phacoemulsification in Children? A Randomized, Prospective Controlled Trial. Curr Eye Res 2011; 36:1139-47. [PMID: 21978235 DOI: 10.3109/02713683.2011.609304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Cem Evereklioglu
- Department of Ophthalmology, Division of Cataract and Refractive Surgery, Erciyes University Medical Faculty,
Kayseri, Turkey
| | - Özgür İlhan
- Department of Ophthalmology, Division of Cataract and Refractive Surgery, Erciyes University Medical Faculty,
Kayseri, Turkey
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Abstract
BACKGROUND Posterior capsule opacification (PCO) remains the most common long-term complication after cataract surgery. It can be treated by Nd:YAG laser capsulotomy, however this may lead to other complications and laser treatment is not available in large parts of the developing world. Therefore, many studies try to find factors influencing the development of PCO. OBJECTIVES To summarise the effects of different interventions to inhibit PCO. These include modifications of surgical technique and intraocular lens (IOL) design, implantation of additional devices and pharmacological interventions. SEARCH STRATEGY We searched CENTRAL, MEDLINE, EMBASE, LILACS in March 2009 and reference lists of identified trial reports. SELECTION CRITERIA We included only prospective, randomised and controlled trials with a follow-up time of at least 12 months. Interventions included modifications in surgical technique explicitly to inhibit PCO, modifications in IOL design (material and geometry), implantation of additional devices and pharmacological therapy compared to each other, placebo or standard treatment. DATA COLLECTION AND ANALYSIS We extracted data and entered it into RevMan. We compared visual acuity data, PCO scores and YAG capsulotomy rates and performed a meta-analysis when possible. MAIN RESULTS Sixty six studies were included in the review. The review was divided into three parts. 1. Influence of IOL optic material on the development of PCO. There was no significant difference in PCO development between the different IOL materials (PMMA, hydrogel, hydrophobic acrylic, silicone) although hydrogel IOLs tend to have higher PCO scores and silicone IOLs lower PCO scores than the other materials. 2. Influence of IOL optic design on the development of PCO. There was a significantly lower PCO score (-8.65 (-10.72 to -6.59), scale 0 to 100) and YAG rate (0.19 (0.11 to 0.35)) in sharp edged than in round edged IOLs, however not between 1-piece and 3-piece IOLs. 3. Influence of surgical technique and drugs on the development of PCO. There was no significant difference between different types of intraoperative/postoperative anti-inflammatory treatment except for treatment with an immunotoxin (MDX-A) which led to a significantly lower PCO rate. AUTHORS' CONCLUSIONS Due to the highly significant difference between round and sharp edged IOL optics, IOLs with sharp (posterior) optic edges should be preferred. There is no clear difference between optic materials. The choice of postoperative anti-inflammatory treatment does not seem to influence PCO development.
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Affiliation(s)
- Oliver Findl
- Hanusch HospitalDepartment of OphthalmologyHeinrich‐Collin‐Strasse 30ViennaAustriaA‐1140
| | - Wolf Buehl
- Medical University of ViennaDepartment of OphthalmologyWähringer Gürtel 18‐20ViennaAustria1090
| | - Peter Bauer
- Medical University of ViennaInstitute of Medical StatisticsSpitalgasse23ViennaAustriaA‐1090
| | - Thomas Sycha
- Medical University of ViennaDepartment of NeurologyWähringer Gürtel 18‐20ViennaAustriaA‐1090
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Asaoka R, Nakagamil T, Zhu H, Liu Y, Hotta Y. The effect of levocabastine hydrochloride on human Tenon’s capsule fibroblasts: Inhibition of proliferation, suppression of DNA synthesis and induction of apoptosis. Cutan Ocul Toxicol 2009; 28:83-9. [DOI: 10.1080/15569520902937901] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ohtani S, Gekka S, Honbou M, Kataoka Y, Minami K, Miyata K, Oshika T. One-year prospective intrapatient comparison of aspherical and spherical intraocular lenses in patients with bilateral cataract. Am J Ophthalmol 2009; 147:984-9, 989.e1. [PMID: 19285656 DOI: 10.1016/j.ajo.2008.12.037] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2008] [Revised: 12/30/2008] [Accepted: 12/31/2008] [Indexed: 11/27/2022]
Abstract
PURPOSE To conduct longitudinal, intrapatient comparisons of aspherical and spherical silicone intraocular lenses (IOL) of the same material and platform in patients undergoing bilateral cataract surgery. DESIGN Prospective, randomized study. METHODS Sixty-two eyes of 31 patients were randomized to receive a silicone aspherical IOL (Tecnis Z9000; AMO Inc, Santa Ana, California, USA) in 1 eye and a silicone spherical IOL (CeeOn 911A; AMO Inc) in the other eye. Best spectacle-corrected visual acuity (BSCVA); corneal and ocular wavefront aberrations; contrast sensitivity under photopic (180 lux), intermediate (75 lux), and scotopic (15 lux) illumination; amount of IOL decentration and tilt; and degree of posterior capsular opacification were measured at 1, 3, 6, and 12 months after surgery. All-distance visual acuity (VA) was measured 3 months after surgery. RESULTS There were no significant differences between IOLs with regard to BSCVA, amount of IOL decentration and tilt, degree of posterior capsule opacification, and all-distance VA at any point after surgery. Regarding corneal wavefront aberrations, there was no difference in third- and fourth-order root mean square (RMS). In ocular wavefront aberrations, aspherical IOLs showed significantly lower fourth-order RMS (P < .001) than spherical IOLs throughout the study, but not in third-order RMS. Contrast sensitivity under photopic and mesopic conditions was not different between IOLs, but contrast sensitivity under scotopic conditions was significantly better with aspherical IOLs than with spherical IOLs (P < .01) at all measurement points. CONCLUSIONS The silicone aspherical IOL (Tecnis Z9000; AMO Inc) significantly reduced ocular spherical aberration and improved scotopic contrast sensitivity, and these results were consistent through the 1-year follow-up.
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11
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Intraindividual Comparison of Aspherical and Spherical Intraocular Lenses of Same Material and Platform. Ophthalmology 2009; 116:896-901. [DOI: 10.1016/j.ophtha.2008.11.022] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Revised: 11/20/2008] [Accepted: 11/24/2008] [Indexed: 11/22/2022] Open
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Wang M, Zhang JJ, Jackson TL, Sun X, Wu W, Marshall J. Safety and efficacy of intracapsular tranilast microspheres in experimental posterior capsule opacification. J Cataract Refract Surg 2008; 33:2122-8. [PMID: 18053915 DOI: 10.1016/j.jcrs.2007.07.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2007] [Accepted: 07/16/2007] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the safety and efficacy of a sustained-release agent designed to reduce posterior capsule opacification (PCO). SETTING Department of Ophthalmology, EENT Hospital, Fudan University, Shanghai, Peoples Republic of China. METHODS Free tranilast (TFree) was incorporated into polylactic acid microspheres and then tested using a rabbit model of PCO. Twenty-nine rabbits were randomized into 5 groups treated with balanced saline solution (BSS control); TFree; or 0.5, 1.0, or 2.0 mg tranilast microspheres (TMicro). Standard phacoemulsification cataract surgery, including manual aspiration of all visible soft lens matter, was performed in all groups. The selected test agent was then injected into the lens capsule. Postoperative clinical examinations were performed at 1, 3, 7, 14, 30, 60, and 90 days. Posterior capsule opacification was quantified using high-resolution computer image analysis at 1, 2, and 3 months. Histological examination was performed at 3 months. RESULTS Eyes treated with TMicro had significantly less PCO than the eyes in the BSS and TFree groups. While the BSS control eyes had increased PCO over 3 months, eyes in the TMicro group had reduced PCO over time in a dose-dependent fashion. Histological examination showed reduced lens epithelial cell proliferation in the TMicro groups, with no manifest damage to the cornea, iris, or retina compared with the BSS controls. There was a transient increase in postoperative inflammation in all tranilast-treated groups compared with the BSS controls. CONCLUSION Sustained-release intracapsular tranilast reduced PCO in an experimental model of PCO, suggesting further investigation of its therapeutic potential is justified.
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Affiliation(s)
- Man Wang
- Department of Ophthalmology, EENT Hospital, Fudan University, Shanghai, Peoples Republic of China.
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Kim HY, Lee HI, Chun YS, Kim JC. The Effectiveness of Tranilast in the Prevention of Posterior Capsular Opacity. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2008. [DOI: 10.3341/jkos.2008.49.12.1981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Ho Young Kim
- Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea
| | | | - Yeoun Sook Chun
- Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jae Chan Kim
- Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Korea
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Abstract
BACKGROUND Posterior capsule opacification (PCO) remains the most common long-term complication after cataract surgery. It can be treated by Nd:YAG laser capsulotomy, however, this may lead to other complications and laser treatment is not available in large parts of the developing world. Therefore, many studies try to find factors influencing the development of PCO. OBJECTIVES To summarise the effects of different interventions to inhibit PCO. These include modifications of surgical technique and intraocular lens (IOL) design, implantation of additional devices and pharmacological interventions. SEARCH STRATEGY We searched CENTRAL, MEDLINE, EMBASE, LILACS in January 2007 and reference lists of identified trial reports. SELECTION CRITERIA We included only prospective, randomised and controlled trials with a follow-up time of at least 12 months. Interventions included modifications in surgical technique explicitly to inhibit PCO, modifications in IOL design (material and geometry), implantation of additional devices, and pharmacological therapy, compared to each other, placebo or standard treatment. DATA COLLECTION AND ANALYSIS Data were extracted and entered into Review Manager. Visual acuity data, PCO score and YAG capsulotomy rates were compared and a meta-analysis was performed when possible. MAIN RESULTS Fifty three studies were included in the review. The review was divided into three parts. (1) Influence of IOL optic material on the development of PCO. Compared to other materials, the meta-analysis of the included studies showed a significantly higher PCO score (overall effect: 12.39 (95% confidence interval: 9.82 to 14.95), scale 0 to 100) and YAG rate (odds ratio: 8.37 (3.74 to 20.36)) only in hydrogel IOLs. (2) Influence of IOL optic design on the development of PCO. There was a significantly lower PCO score (-8.65 (-10.72 to -6.59), scale 0 to 100) and YAG rate (0.19 (0.11 to 0.35)) in sharp edged than in round edged IOLs, however, not between 1-piece and 3-piece IOLs. (3) Influence of surgical technique and drugs on the development of PCO. There was no significant difference between different types of intra-/postoperative anti-inflammatory treatment except for treatment with an immunotoxin (MDX-A) leading to a significantly lower PCO rate. AUTHORS' CONCLUSIONS Due to the highly significant difference between round and sharp edge IOL optics, IOLs with sharp (posterior) optic edges should be preferred. There is no clear difference between optic materials, except for hydrogel IOLs, that showed more PCO than the other materials. The choice of postoperative anti-inflammatory treatment does not seem to influence PCO development.
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Affiliation(s)
- O Findl
- Medical University of Vienna, Department of Ophthalmology, Allgemeines Krankenhaus Wien, Währinger Gürtel 18-20, Vienna, Austria, A-1090.
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Bras ID, Colitz CMH, Saville WJA, Gemensky-Metzler AJ, Wilkie DA. Posterior capsular opacification in diabetic and nondiabetic canine patients following cataract surgery. Vet Ophthalmol 2006; 9:317-27. [PMID: 16939460 DOI: 10.1111/j.1463-5224.2006.00458.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Posterior capsular opacification (PCO) is the most common postoperative complication of contemporary cataract surgery. Limited information is available regarding PCO formation and factors that influence PCO development in the dog. Two hundred sixty-five eyes (144 from diabetic dogs and 121 from dogs with breed-related cataracts) were prospectively evaluated for PCO formation for up to 12 months postoperatively. The mean age of all dogs in the study was 7.77 years and diabetic dogs were significantly older than dogs with breed-related cataracts. There were 73 males (61 neutered, 12 intact) and 74 females (70 neutered, 4 intact) in the study. Statistical analysis was performed based on age, breed/size, gender, stage of cataract at the time of surgery, PCO score at each time point, breed-related vs. diabetic cataract, right eyes compared to left eyes, and presence/absence of uveitis. Age and gender did not significantly influence PCO formation. Small and medium-sized breeds developed significantly more PCO in comparison to the large/giant breeds at 2 weeks and 2-4 months postoperatively, but the differences were not significant at later time points. There was an overall significant increase in PCO formation in eyes with early immature cataracts when compared to other stages of cataract up to 4 months postoperatively but not at later time points. There were no statistical differences in PCO score at 6 months or at 1 year postoperatively in eyes with breed-related and diabetic cataracts. Right eyes did not differ from left eyes in PCO score. PCO score significantly increased over time in breed-related and diabetic groups and in the overall population. No difference was found in the degree of PCO formation in eyes with inflammation prior to or after surgery compared with those without inflammation. In summary, age, gender, presence of inflammation, and cause of cataract (breed-related vs. diabetes mellitus) do not influence the development of PCO in canine cataract dogs. Small and medium-sized breeds develop significant PCO earlier than larger breeds. It is important to note that all eyes from all dogs in this study developed PCO in a time dependent manner.
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Affiliation(s)
- I Dineli Bras
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH 43210, USA
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Nejima R, Miyai T, Kataoka Y, Miyata K, Honbou M, Tokunaga T, Kawana K, Kiuchi T, Oshika T. Prospective Intrapatient Comparison of 6.0-Millimeter Optic Single-Piece and 3-Piece Hydrophobic Acrylic Foldable Intraocular Lenses. Ophthalmology 2006; 113:585-90. [PMID: 16581420 DOI: 10.1016/j.ophtha.2005.10.064] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2005] [Revised: 10/26/2005] [Accepted: 10/27/2005] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To compare postoperative performance and stability of 6.0-mm optic single- and 3-piece acrylic foldable intraocular lenses (IOLs). DESIGN Prospective, randomized, self-controlled trial. PARTICIPANTS Eighty eyes of 40 patients with bilateral senile cataracts. INTERVENTION Phacoemulsification and IOL implantation were performed. One eye of a patient was randomly assigned to the SA60AT single-piece IOL, and the contralateral eye was allocated to the MA60AC 3-piece IOL. MAIN OUTCOME MEASURES Best-corrected visual acuity (BCVA), spherical equivalent, aqueous flare intensity, anterior chamber depth, amount of IOL decentration and tilt, area of anterior capsule opening, and degree of posterior capsule opacification (PCO) were measured 2 days, 1 week, and 1, 3, 6, and 12 months after surgery. Specular microscopy was performed at 12 months postoperatively. RESULTS In the SA60AT group, the anterior chamber depth did not show significant changes after surgery (P>0.05; paired t test), and the refraction remained highly stable throughout the 1-year study period. The MA60AC group showed significant shallowing of the anterior chamber (P<0.05) and a myopic shift (P<0.05) up to 1 month after surgery. There were no significant differences between the 2 groups (P>0.05) in BCVA, aqueous flare intensity, the amount of IOL decentration, IOL tilt, area of anterior capsule opening, and degree of PCO throughout the 12-month follow-up period. CONCLUSIONS Both the SA60AT single-piece and MA60AC 3-piece lenses showed a minimum amount of decentration, tilt, anterior capsule contraction, and PCO. Although the MA60AC showed significant forward shift and myopic refractive changes after surgery, the SA60AT displayed little axial movement associated with highly stable refraction after surgery. This feature of the SA60AT should facilitate earlier spectacle prescription and quicker visual/social rehabilitation of patients after cataract surgery.
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Affiliation(s)
- Ryohei Nejima
- Meiwakai Medical Foundation, Miyata Eye Hospital, Miyazaki, Japan
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Matsushima H, Mukai K, Gotoo N, Yoshida S, Yoshida T, Sawano M, Senoo T, Obara Y, Clark JI. The Effects of Drug Delivery Via Hydrophilic Acrylic (Hydrogel) Intraocular Lens Systems on the Epithelial Cells in Culture. Ophthalmic Surg Lasers Imaging Retina 2005. [DOI: 10.3928/1542-8877-20050901-07] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Auffarth GU, Rabsilber TM, Reuland AJ. [New methods for the prevention of posterior capsule opacification]. Ophthalmologe 2005; 102:579-86. [PMID: 15889259 DOI: 10.1007/s00347-005-1234-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Even though tremendous advances have been made especially during the last 10-15 years in terms of surgical techniques and improvement of implant technology, posterior capsule opacification (PCO) still remains a serious long-term complication. New clinical and laboratory studies (especially of autopsy eyes) have improved our understanding of how IOL design and material influence PCO. Sharp edge optic designs of IOLs of various materials have been shown to significantly reduce secondary cataract. The application of pharmacological substances selectively into the capsular bag is now possible due to the development of the PerfectCapsule System for vacuum-sealed capsule irrigation. Major advances in other areas of biotechnology and immunology including gene therapeutic methods offer totally new approaches for the future in the elimination of lens epithelium cells from the capsular bag. This survey gives an update on current and future means and trends to reduce or prevent PCO formation.
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Affiliation(s)
- G U Auffarth
- Augenklinik, Ruprecht-Karls-Universität, Heidelberg.
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Nejima R, Miyata K, Honbou M, Tokunaga T, Tanabe T, Sato M, Oshika T. A prospective, randomised comparison of single and three piece acrylic foldable intraocular lenses. Br J Ophthalmol 2004; 88:746-9. [PMID: 15148204 PMCID: PMC1772204 DOI: 10.1136/bjo.2003.037663] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To compare the postoperative performance of single and three piece acrylic foldable intraocular lenses (IOLs). METHODS 20 patients underwent bilateral cataract surgery with a single piece SA30AL IOL in one eye and a three piece MA30BA IOL in the other eye. The eyes were randomly assigned to either a single or three piece lens. The amount of IOL decentration and tilt, area of anterior capsule opening, and degree of posterior capsule opacification were measured using the Scheimpflug anterior segment analysis system (Nidek EAS-1000). Visual acuity and contrast sensitivity were examined. Measurements were performed by masked examiners before and 1 day, 1 week, 1, 3, 6, and 18 months after surgery. RESULTS There were no significant differences between the two groups (p>0.05, paired t test) in the amount of IOL decentration, IOL tilt, area of anterior capsule opening, degree of posterior capsule opacification, best corrected visual acuity, and contrast sensitivity throughout the 18 month follow up period. CONCLUSION The single and three piece acrylic foldable IOLs are equally stable in the eye after surgery.
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Affiliation(s)
- R Nejima
- Miyata Eye Hospital, Miyazaki, Japan
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Tanaka Y, Kato S, Miyata K, Honbo M, Nejima R, Kitano S, Amano S, Oshika T. Limitation of Scheimpflug videophotography system in quantifying posterior capsule opacification after intraocular lens implantation. Am J Ophthalmol 2004; 137:732-5. [PMID: 15059713 DOI: 10.1016/j.ajo.2003.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2003] [Indexed: 11/22/2022]
Abstract
PURPOSE To assess the applicability of Scheimpflug videophotography system for the quantitative comparison of posterior capsule opacification after intraocular lens (IOL) implantation of different materials. DESIGN Retrospective, nonrandomized, interventional case series. METHODS Three groups (n = 15 eyes, each) underwent cataract surgery with implantation of acrylic, silicone, or hydrogel IOL. One year after surgery, the scatter light density at the anterior IOL surface level was measured using EAS-1000. Another three groups (n = 32 eyes, each) received acrylic, silicone, or hydrogel lens. One week after surgery, the scatter light density at the posterior capsule was measured. RESULTS Scatter light density at the anterior IOL surface 1 year after implantation was 7.5 +/- 3.0 computer-compatible tape (CCT) steps in the acrylic group, 6.0 +/- 2.3 CCT steps in the silicone group, and 5.0 +/- 3.2 CCT steps in the hydrogel group; the density in the acrylic group was significantly greater than that in the hydrogel group (P =.026). Scatter light density at the posterior capsule level 1 week after surgery was 28.3 +/- 8.9 CCT steps in the acrylic group, 22.2 +/- 2.0 CCT steps in the silicone group, and 26.7 +/- 6.7 CCT steps in the hydrogel group; there was a significant difference between the acrylic and silicone groups (P =.0005) and between the silicone and hydrogel groups (P =.008). CONCLUSIONS The IOL material significantly influences the scatter light density measurements of Scheimpflug videophotography system, and thus the intensity of posterior capsule opacification quantified by this system cannot be directly compared with different optic materials.
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Affiliation(s)
- Yoshikazu Tanaka
- Department of Ophthalmology, Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan
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21
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Nishihara H, Yaguchi S, Onishi T, Chida M, Ayaki M. Surface scattering in implanted hydrophobic intraocular lenses. J Cataract Refract Surg 2003; 29:1385-8. [PMID: 12900250 DOI: 10.1016/s0886-3350(02)01994-6] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To describe surface scattering, a new phenomenon in polyacrylic intraocular lenses (IOLs), and discuss the possible cause of this finding. SETTING Showa University, Fujigaoka Hospital, Yokohama, Kanagawa, Japan. METHODS This observational case series involved 40 patients who received the AcrySof(R) IOL (Alcon Laboratories, Inc.) as part of a clinical trial in 1991. Four patients (5 eyes) were evaluated. Thirty-three patients had the same surgery in 1999, and the findings in these patients were compared with those in the earlier patients. Lens surface scattering was evaluated by area densitometry using Scheimpflug photography. No statistical analysis was done because of the small sample size. RESULTS The 5 IOLs implanted in 1991 showed various degrees of surface scattering. The degree of scattering was greater than that in the 1999 group. There was no degradation in visual performance and no manifestation of intraocular inflammation or other adverse effect from the IOLs in either group. Attempts to remove foreign material on the IOL using the neodymium:YAG (Nd:YAG) laser were unsuccessful. CONCLUSIONS The surface scattering did not appear to be due to deposition of foreign material on the IOL surface. Densitometry and the results of Nd:YAG laser treatment suggest that the changes occurred in the near-surface layer. Phase separation of water near the IOL surface in the inherently hydrophobic material may explain the phenomenon. Newer AcrySof IOLs appear to have less surface scattering.
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Affiliation(s)
- Hitoshi Nishihara
- Department of Ophthalmology, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
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Abstract
The introduction of the anti-cancer drugs Mitomycin and 5-fluorouracil as anti-scarring agents within the last decade, has greatly improved surgical results of glaucoma filtration surgery. However, a number of problems associated with their use have emerged. At the same time, the transforming growth factor-beta (TGF-beta) has been identified as an important component of wound healing, particularly in the conjunctival scarring response. Recent developments in molecular therapy offer exciting prospects for the modulation of wound healing, specifically those targeting TGF-beta. As TGF-beta is such a potent stimulant of scarring, this review examines its biology and role in ocular wound healing and repair, and discusses promising new approaches to modifying its activity.
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Affiliation(s)
- M Francesca Cordeiro
- Department of Pathology, Institute of Ophthalmology and Moorfields Eye Hospital, Bath Street, London EC1V 9EL, UK.
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Abstract
Posterior capsule opacification (PCO) is still the most frequent complication of cataract surgery. A variety of studies has led to a better understanding of the pathogenesis of PCO, and strategies of molecular biology have produced new therapeutic options, such as immunological techniques or gene therapeutic approaches. Surgical strategies and intra-ocular lens-dependent factors also are capable to reduce the rate of PCO. In-the-bag implantation of intra-ocular lenses with a sharp optic edge seems to be effective in inhibiting equatorial lens epithelial cell migration to the center of the posterior capsule. Several PCO documentation systems have been developed that will lead to more exact and better comparable recording of PCO rates. In the year 2000, PCO or secondary cataract is still the most frequent complication after extracapsular cataract surgery. In a 1998 meta-analysis, PCO rates of 11.8% 1 year after extracapsular cataract surgery with intraocular lens implantation, 20.7% after 3 years, and 28.4 % after 5 years have been reported. For the United States, it has been estimated that the overall expenses for treatment of PCO are only exceeded by the costs for cataract treatment itself. In the past decade, a lot of experimental and clinical studies have been performed on this topic. They have led to 1) to a better understanding of the pathogenesis of the development of anterior and posterior capsule opacification; 2) more objective and better comparable systems of documentation and analysis of PCO; and a number of 3) surgical and 4) pharmaceutical strategies to prevent PCO.
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Affiliation(s)
- E Bertelmann
- Eye Department, Charité Campus Virchow Hospital, Humboldt University Berlin, Berlin, Germany.
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