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Huang F, Tong W, Wang D, Guan W, Zhang Z, Zhao YE. Impact of anterior capsule polishing on capsule opacification and capsule bend after age-related cataract surgery. J Cataract Refract Surg 2024; 50:599-604. [PMID: 38270489 PMCID: PMC11146178 DOI: 10.1097/j.jcrs.0000000000001407] [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: 10/02/2023] [Revised: 12/25/2023] [Accepted: 01/13/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE To investigate the effect of anterior capsule polishing on postoperative capsule opacification and capsular bend in patients with age-related cataract displaying normal axial length. SETTING Eye Hospital of Wenzhou Medical University at Hangzhou. DESIGN Prospective self-controlled trial. METHODS Patients with age-related cataracts aged 56 to 84 years displaying normal axial length were enrolled. Before surgery, a coin-toss method was used to randomly select 1 eye for intraoperative 360 degrees anterior capsule polishing (polishing group); the contralateral eye received no treatment (control group). Capsular bend index (CBI), anterior capsule opacification (ACO), posterior capsule opacification (PCO), and anterior capsule opening area (ACOA) were recorded at 1 week, 1 month, 3 months, 6 months, and 12 months postoperatively using swept-source optical coherence tomography and slitlamp examination. RESULTS 21 patients (42 eyes) were enrolled. Within-group comparisons showed that both groups had significant differences in CBI between 1 week and 1 month postoperatively, and between 6 months and 12 months postoperatively ( P < .05). Between-group comparisons revealed a significant difference in CBI at 1 week postoperatively ( P < .05); at 12 months postoperatively, there was a significant difference in ACOA ( P < .05). There were no significant between-group differences regarding ACO or PCO at any timepoint ( P > .05). CONCLUSIONS For patients with age-related cataracts and normal axial length, 360 degrees anterior capsule polishing can delay early capsular bag deformation without increasing the risks of ACO and PCO. This approach can also limit contraction of the anterior capsule opening.
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Affiliation(s)
- Feng Huang
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
| | - Wentao Tong
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
| | - Dandan Wang
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
| | - Weichen Guan
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
| | - Zhewen Zhang
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
| | - Yun-e Zhao
- From the National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China; Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou, China
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2
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Srinija K, Bhat SK, Prasad KHL. Comparative histomorphologic study of basement membrane side staining and additional epithelial side staining of the anterior lens capsule with Trypan Blue. Indian J Ophthalmol 2024; 72:578-581. [PMID: 38146976 PMCID: PMC11149509 DOI: 10.4103/ijo.ijo_1558_23] [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: 06/14/2023] [Accepted: 10/19/2023] [Indexed: 12/27/2023] Open
Abstract
PURPOSE To compare the histomorphologic changes on the anterior lens capsule by both epithelial and basement membrane side staining to those of only basement membrane side staining of the anterior lens capsule with Trypan Blue (TB). METHODS A cross-sectional study was done on 72 samples from patients who underwent cataract surgery between April 2021 and September 2022. After capsulorhexis of the TB-stained capsule, it was made into two halves externally and one half labeled as controls (sample A). The other half was immediately stained further with TB on the epithelial side and was taken as cases (sample B). Samples were analyzed for lens epithelial cells and basement membrane changes. RESULTS The loss of intactness of lens epithelial cells, partial or complete detachment of lens epithelial cells, degeneration of lens epithelial cells, and basement edema were significantly higher in cases compared to controls, whereas intactness of the basement membrane did not show any statistical significance between the two groups. There was a statistically significant decrease in cell density in cases compared to controls. CONCLUSION Staining the epithelial side of the capsular bag with TB is more detrimental to lens epithelial cells and paves the way for a further study of staining the capsular bag before intra-ocular lens implantation to reduce the incidence of posterior capsule opacification.
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Affiliation(s)
- Kommana Srinija
- Department of Ophthalmology, K. S. Hegde Medical Academy of Nitte DU, Deralakatte, Mangalore, Karnataka, India
| | - Subrahmanya K Bhat
- Department of Ophthalmology, K. S. Hegde Medical Academy of Nitte DU, Deralakatte, Mangalore, Karnataka, India
| | - Kishan H L Prasad
- Department of Pathology, K. S. Hegde Medical Academy of Nitte DU, Deralakatte, Mangalore, Karnataka, India
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Fang Q, Qin C, Duo L, Fei F, Jia Q, Chen H, Lin Q. Polydopamine based photothermal/photodynamic synchronous coating modified intraocular lens for efficient and safer posterior capsule opacification prevention. BIOMATERIALS ADVANCES 2024; 158:213792. [PMID: 38281322 DOI: 10.1016/j.bioadv.2024.213792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/26/2023] [Accepted: 01/23/2024] [Indexed: 01/30/2024]
Abstract
Posterior capsule opacification (PCO), as one of the most common late complications after intraocular lens (IOL) implantation in cataract surgery, seriously affects patients' postoperative vision and surgical satisfaction, and can only be treated by laser incision of the posterior capsule. Although drug eluting coating modification have been proved to inhibit PCO effectively, the complicated coating methods and the potential toxicity of the antiproliferative drugs hinders its actual application. In this study, an indocyanine green (ICG) loaded polydopamine (PDA) coating modified IOL (IP-IOL) was designed to prevented PCO. In vitro and in vivo studies have shown that IP-IOL can effectively eliminate lens epithelial cells and significantly reduce the degree of PCO. At the same time, it still has good imaging quality and optical properties. Furthermore, both the near-infrared irradiation and ICG loaded PDA coating modified IOLs have proved to possess high biological safety to eyes. Thus, with easy preparation and safer near-infrared irradiated photothermal/photodynamic synchronous properties, such ICG loaded PDA coating provides an effective yet easier and safer PCO prevention after IOL implantation.
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Affiliation(s)
- Qiuna Fang
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Chen Qin
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Lan Duo
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Fan Fei
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Qingqing Jia
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
| | - Hao Chen
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China.
| | - Quankui Lin
- National Engineering Research Center of Ophthalmology and Optometry, School of Biomedical Engineering, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China.
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Lee Y, Kim JS, Kim BG, Hwang JH, Kang MJ, Lee JH. Comparison of the Incidence of Nd:YAG Laser Capsulotomy Based on the Type of Intraocular Lens. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2173. [PMID: 38138276 PMCID: PMC10744545 DOI: 10.3390/medicina59122173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Posterior capsular opacification (PCO) is the most common long-term complication of successful cataract surgery and can cause visual impairment. We aimed to investigate the effects of intraocular lens (IOL) characteristics on PCO by comparing the incidence of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy for different types of intraocular lenses. Materials and Methods: A retrospective analysis was performed on 2866 eyes that underwent cataract surgery between January 2010 and December 2017, with at least 5 years of follow-up. The IOLs used for surgery were the hydrophobic lenses SN60WF (Alcon, Fort Worth, TX, USA), ZCB00 (Johnson & Johnson Vision, Santa Ana, CA, USA), and MX60 (Bausch & Lomb, Rochester, NY, USA), and the hydrophilic lens MI60 (Bausch & Lomb, Rochester, NY, USA). We analyzed the incidence of Nd:YAG laser capsulotomy according to the type of IOL used. Results: The incidence of Nd:YAG laser capsulotomy was significantly higher with MI60 lenses (31.70%, 175/552 eyes) compared to SN60WF (7.90%, 113/1431 eyes), ZCB00 (10.06%, 64/636 eyes), and MX60 (10.57%, 13/123 eyes; p < 0.001) lenses. The incidence of Nd:YAG laser capsulotomy was significantly lower with the hydrophobic IOLs (8.68%, 190/2190 eyes) than with the hydrophilic IOL (31.70%, 175/552 eyes; p < 0.001). Over time, the rate of increase in the cumulative number of Nd:YAG laser capsulotomy cases was the highest with MI60. The cumulative rate of Nd:YAG laser capsulotomy during the first 3 years was 4.90% with SN60WF (70/1431 eyes), 6.76% with ZCB00 (43/636 eyes), 8.94% with MX60 (11/123 eyes), and 26.10% with MI60 (144/552 eyes) lenses. Conclusions: The incidence of PCO is influenced by the material of the IOLs. The hydrophilic IOL was associated with a higher rate of Nd:YAG laser capsulotomy than the hydrophobic IOLs, with a shorter time to Nd:YAG laser capsulotomy.
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Affiliation(s)
| | | | | | | | | | - Jee Hye Lee
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Republic of Korea; (Y.L.); (J.S.K.); (B.G.K.); (J.H.H.); (M.J.K.)
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5
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Li X, Li J, Sun D, Ma T, Chen W, Ye Z, Li Z. Development and Validation of a Prediction Model for Nd:YAG Laser Capsulotomy: A Retrospective Cohort Study of 9768 eyes. Ophthalmol Ther 2023; 12:1893-1912. [PMID: 37133707 PMCID: PMC10287599 DOI: 10.1007/s40123-023-00723-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/20/2023] [Indexed: 05/04/2023] Open
Abstract
INTRODUCTION Posterior capsular opacification (PCO) is the most common complication of cataract surgery. In this study, we develop a model to quantitatively predict the probability of Nd:YAG laser capsulotomy for vision-threatening PCO to improve the life quality of postoperative patients. METHODS A registry analysis of cataract procedures performed between the years 2010 and 2021. Following the screening of 16,802 patients (25,883 eyes), 9768 patients (eyes) were enrolled. The cohort was randomly divided into two groups: training (n = 6838) and validation (n = 2930). To identify relevant risk factors, univariate, multivariate, and Least Absolute Shrinkage and Selection Operator (LASSO) algorithm Cox regression analysis were employed, and a nomogram was created to demonstrate the prediction result. RESULTS At 5 years, the overall cumulative incidence of Nd:YAG laser capsulotomy was 12.0% (1169/9768). The following variables were included in the prediction model: sex [hazard ratio (HR) = 1.53, 95% CI 1.32-1.76], age (HR = 0.71, 95% CI 0.56-0.88), intraocular lens (IOL) material (HR = 2.65, 95% CI 2.17-3.24), high myopia (HR = 2.28, 95% CI 1.90-2.75), and fibrinogen (HR = 0.79, 95% CI 0.72-0.88). In the validation cohort, the area under the curve (AUC) of 1-, 3-, and 5-year predictions for Nd:YAG laser capsulotomy were 0.702, 0.691, and 0.688, respectively. For a subgroup of patients with high myopia, the protective effect of hydrophobic IOL disappeared (HR = 0.68, 95% CI 0.51-1.12, P = 0.127). CONCLUSION This model could predict the probability of Nd:YAG laser capsulotomy for vision-threatening PCO after cataract surgery by taking into account factors such as age, gender, IOL material, high myopia, and fibrinogen. Meanwhile, implantation of a hydrophobic IOL in individuals with high myopia did not demonstrate a protective impact against vision-threatening PCO.
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Affiliation(s)
- Xuanlong Li
- Medical School of Chinese PLA, Beijing, 100853 China
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, 100039 China
| | - Jinglan Li
- Medical School of Chinese PLA, Beijing, 100853 China
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, 100039 China
| | - Di Sun
- Medical School of Chinese PLA, Beijing, 100853 China
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, 100039 China
| | - Tianju Ma
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, 100039 China
| | - Wenqian Chen
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, 100039 China
| | - Zi Ye
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, 100039 China
| | - Zhaohui Li
- Department of Ophthalmology, The Third Medical Center, Chinese PLA General Hospital, Beijing, 100039 China
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"Comparing outcomes of advanced nurse practitioners to ophthalmologists performing posterior YAG capsulotomy, a six-year study of 6308 eyes". Eye (Lond) 2023; 37:554-559. [PMID: 35228691 PMCID: PMC8884414 DOI: 10.1038/s41433-022-01986-8] [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] [Received: 01/24/2021] [Revised: 01/29/2022] [Accepted: 02/10/2022] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To primarily report the baseline characteristics and visual acuity (VA) outcomes of advanced nurse practitioners (ANP) compared to ophthalmologists following YAG posterior capsulotomy (YAGPC). We secondarily looked to characterise the risk factors that lead to a repeated YAGPC. METHOD Retrospective consecutive case series of 6,308 eyes attending the Birmingham and Midlands Eye Centre. RESULTS ANPs performed 33.1% of YAGPC compared to 66.9% ophthalmologists. Compared to ophthalmologists, ANPs performed YAGPC in lower proportion of patients with ocular co-morbidities (p < 0.001) and had lower proportion of patients requiring further YAGPC compared to ophthalmologists (p < 0.001). Median pre, post-operative and LogMAR gain in VA of 0.48 (IQR 0.30-0.78), 0.18 (IQR 0.10-0.40) and 0.30 (0.08-0.48) LogMAR units, respectively. Multivariate regression showed that ANPs had a significantly lower rate of repeat YAGPC compared to ophthalmologists even when adjusting for age, ethnicity, training grade and ocular co-morbidities. No difference in visual outcomes was found between operator grade and ethnicity on multivariate analysis. CONCLUSION YAGPC leads to excellent visual outcomes. ANPs can deliver safe and effective YAGPC.
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7
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Hecht I, Kanclerz P, Tuuminen R. Secondary outcomes of lens and cataract surgery: More than just “best-corrected visual acuity”. Prog Retin Eye Res 2022:101150. [DOI: 10.1016/j.preteyeres.2022.101150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/07/2022] [Accepted: 11/20/2022] [Indexed: 12/12/2022]
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Ling R, Borkenstein EM, Borkenstein AF. Evaluation of Nd:YAG Laser Capsulotomy Rates in a Real-Life Population. Clin Ophthalmol 2020; 14:3249-3257. [PMID: 33116375 PMCID: PMC7569058 DOI: 10.2147/opth.s276329] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/05/2020] [Indexed: 11/23/2022] Open
Abstract
Objective The objective of this study was to assess the rate of posterior capsule opacification (PCO), under “real-life” conditions, as measured by rates of Nd:YAG laser intervention, rather than from a controlled study from which patients with conditions predisposing to PCO have been excluded. Methods and Analysis This was a retrospective, multicenter study in an unselected consecutive cohort of patients undergoing surgery for senile cataract. Patients aged 18 years and older, previously implanted with the CT LUCIA 611P IOL, were contacted at 12, 18 and 24 months to ascertain if they had received Nd:YAG laser treatment. There was an additional assessment at 36 months at the Austrian centre. Results A total of 200 patients were recruited at two centers. Laser capsulotomy rates were 4.5% at 1 year and 10% by year 2 and 12% by year 3. Three Nd:YAG capsulotomies, carried out at other external centers, were performed for reasons other than PCO, including astigmatism, epiretinal membrane and ARMD. If these patients are excluded, the true rate of Nd:YAG carried out for PCO at 1 year was 3.5% and at 2 years was 8.5%. Conclusion It is critical to ensure that Nd:YAG capsulotomies are being performed only for the correct clinical reason. Carrying out unnecessary procedures places the patient at risk of adverse events, is a cost to the healthcare system, and is likely to have no direct visual benefit for the patient. In PCO studies, it should be a requirement to document the fibrosis grade to confirm that Nd:YAG capsulotomy was correctly indicated.
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Affiliation(s)
- Roland Ling
- The Medical Eye Clinic, Royal Devon and Exeter Hospital, Exeter, UK
| | - Eva-Maria Borkenstein
- Privatklinik der Kreuzschwestern Graz, Private Practice Borkenstein & Borkenstein, Graz, Austria
| | - Andreas F Borkenstein
- Privatklinik der Kreuzschwestern Graz, Private Practice Borkenstein & Borkenstein, Graz, Austria
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Cinar E, Yuce B, Aslan F, Erbakan G, Küçükerdönmez C. Intraocular lens tilt and decentration after Nd:YAG laser posterior capsulotomy: Femtosecond laser capsulorhexis versus manual capsulorhexis. J Cataract Refract Surg 2020; 45:1637-1644. [PMID: 31706518 DOI: 10.1016/j.jcrs.2019.07.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/11/2019] [Accepted: 07/09/2019] [Indexed: 12/16/2022]
Abstract
PURPOSE To compare intraocular lens (IOL) tilt and decentration after Nd:YAG laser posterior capsulotomy in eyes that had femtosecond laser-assisted capsulotomy versus manual capsulorhexis. SETTING Ekol Eye Hospital, Izmir, Turkey. DESIGN Retrospective case series. METHODS Intraocular lens decentration and angle of tilt were measured using a Scheimpflug camera before and 1 month after Nd:YAG capsulotomy. RESULTS Eighteen eyes had a femtosecond laser-assisted capsulotomy and 25 eyes a manual capsulorhexis. The mean age was 58.2 years ± 10.2 (SD) (range 44 to 69 years) and 60.6 ± 8.3 years (range 45 to 70 years), respectively. Before capsulotomy, the angle of tilt and decentration at both meridians did not differ significantly between the 2 groups (P > .05). After capsulotomy, the angle of tilt was significantly decreased in both groups (femtosecond: vertical 1.5 degrees and horizontal 1.2 degrees; manual: vertical 1.1 degrees and horizontal) and decentration was significantly increased (femtosecond: vertical 0.085 mm and horizontal 0.096 mm; manual: vertical 0.2 mm and horizontal 0.2 mm) at both meridians (P < .05). After capsulotomy, all tilt and decentration parameters were significantly different between the 2 groups (P < .05) except decentration on the horizontal meridian (P = .669). CONCLUSIONS Nd:YAG posterior capsulotomy performed after femtosecond laser-assisted capsulotomy resulted in better mechanical stability of the IOL. This suggests that a femtosecond laser-created capsulotomy better maintains a proper IOL position. Although the differences were statistically significant, the tilt and decentration values were small and might not be clinically significant.
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Affiliation(s)
| | - Berna Yuce
- University of Health Sciences, İzmir Tepecik Training and Research Hospital Ophthalmology Clinic, İzmir, Turkey
| | - Fatih Aslan
- Alaattin Keykubat University, Department of Ophthalmology, Alanya, Antalya, Turkey
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Leydolt C, Schartmüller D, Schwarzenbacher L, Röggla V, Schriefl S, Menapace R. Posterior Capsule Opacification With Two Hydrophobic Acrylic Intraocular Lenses: 3-Year Results of a Randomized Trial. Am J Ophthalmol 2020; 217:224-231. [PMID: 32335056 DOI: 10.1016/j.ajo.2020.04.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare the incidence and intensity of posterior capsule opacification (PCO) and neodymium-yttrium-aluminum-garnet (Nd:YAG) capsulotomy rates between 2 similar open-loop single-piece hydrophobic acrylic intraocular lenses (IOLs) that differ in the proprietary material characteristics and design features, over a period of 3 years. DESIGN Randomized, prospective, patient- and examiner-masked clinical trial with intraindividual comparison. METHODS Setting: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. PATIENT POPULATION Eighty patients (160 eyes) had bilateral cataract surgery and received a Vivinex XY1 IOL in 1 eye and an AcrySof SN60WF IOL in the other eye. OBSERVATION PROCEDURES Follow-up examinations were performed 3 years after surgery. Digital retroillumination images were taken of each eye. The amount of PCO (score: 0-10) was assessed subjectively at the slit lamp and objectively using automated image analysis software (AQUA). MAIN OUTCOME MEASURE PCO score (scale, 0-10). RESULTS The mean objective PCO score of the Vivinex XY1 IOLs was 0.9 ± 0.8 compared to the PCO score of 1.4 ± 1.1 for the AcrySof SN60WF IOLs (P < .001). Three years postoperatively, 11.4% of patients had an Nd:YAG capsulotomy in the Vivinex XY1 eye and 18.6% had a capsulotomy in the AcrySof SN60WF eye (P = .23). CONCLUSION The new hydrophobic acrylic Vivinex XY1 IOL showed significantly lower PCO rates and lower YAG rates compared to the AcrySof SN60WF IOL. The interaction of various factors such as hydrophobic material, smooth optic surface, and sharp posterior optic edge plays a key role in PCO development.
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11
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Hecht I, Dubinsky‐Pertzov B, Karesvuo P, Achiron A, Tuuminen R. Association between intraocular lens diopter and posterior capsular opacification. Clin Exp Ophthalmol 2020; 48:889-894. [DOI: 10.1111/ceo.13821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/04/2020] [Accepted: 07/04/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Idan Hecht
- Helsinki Retina Research Group University of Helsinki Helsinki Finland
- Department of Ophthalmology, Shamir Medical Center and Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Biana Dubinsky‐Pertzov
- Department of Ophthalmology, Shamir Medical Center and Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Petteri Karesvuo
- Helsinki Retina Research Group University of Helsinki Helsinki Finland
- Department of Ophthalmology Helsinki University Hospital Helsinki Finland
| | - Asaf Achiron
- Department of Ophthalmology, Wolfson Medical Center, Holon and Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Raimo Tuuminen
- Helsinki Retina Research Group University of Helsinki Helsinki Finland
- Eye Centre Kymenlaakso Central Hospital Kotka Finland
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12
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Leydolt C, Schartmüller D, Schwarzenbacher L, Schranz M, Schriefl S, Menapace R. Comparison of posterior capsule opacification development with 2 single-piece intraocular lens types. J Cataract Refract Surg 2019; 43:774-780. [PMID: 28732611 DOI: 10.1016/j.jcrs.2017.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/07/2017] [Accepted: 03/23/2017] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the differences in the incidence of posterior capsule opacification (PCO) and visual and optical performance between 2 hydrophobic acrylic single-piece sharp-edged intraocular lenses (IOLs) over 3 years. SETTING Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. DESIGN Prospective randomized case series. METHODS Patients with bilateral cataract were prospectively randomized to receive an Eyecee One IOL (IOL A) or an Acrysof SN60WF IOL (IOL B) and were followed for 36 months. The corrected distance visual acuity (CDVA) and IOL decentration and tilt were measured. The PCO was quantified by analysis of standardized retroillumination images. RESULTS The study comprised 160 eyes of 80 patients. The PCO incidence was low for both IOLs at all follow-up visits. Three years postoperatively, the median objective PCO score was 1.4 (range 0 to 5.6) for IOL A and 1.5 (range 0 to 5.0) for IOL B (P = .67). The neodymium:YAG (Nd:YAG) capsulotomy rate 3 years after surgery was 16.4% and 6.0% (P = .06), respectively. Visual acuity and contrast sensitivity outcomes were also comparable at all follow-up visits. CONCLUSIONS Both IOLs showed good capsular bag performance and low PCO rates 3 years after surgery. Both IOLs also showed comparable results for visual acuity, contrast sensitivity, decentration and tilt, PCO score, slitlamp examination, and Nd:YAG capsulotomy rates.
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Affiliation(s)
- Christina Leydolt
- From the Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Daniel Schartmüller
- From the Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Luca Schwarzenbacher
- From the Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Markus Schranz
- From the Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Sabine Schriefl
- From the Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Rupert Menapace
- From the Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
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13
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5 year incidence of YAG capsulotomy and PCO after cataract surgery with single-piece monofocal intraocular lenses: a real-world evidence study of 20,763 eyes. Eye (Lond) 2019; 34:960-968. [PMID: 31616057 PMCID: PMC7182577 DOI: 10.1038/s41433-019-0630-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 08/07/2019] [Accepted: 09/03/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To evaluate the 3- and 5-year incidence of posterior capsule opacification (PCO) and neodymium-doped yttrium aluminium garnet (Nd:YAG) capsulotomy in patients following cataract surgery, comparing results for different single-piece acrylic hydrophilic and hydrophobic monofocal intraocular lens (IOL) models and other patient factors. PATIENTS AND METHODS Electronic medical record data collected from seven United Kingdom (UK) National Health Service (NHS) ophthalmology clinics for routine, age-related (≥65 years) cataract surgeries that implanted single-piece acrylic monofocal IOLs during 2010-2013 were used to calculate 3- and 5-year incidence of Nd:YAG and PCO. IOL models of Alcon Acrysof, AMO Tecnis, Bausch & Lomb (B & L) Akreos, LenStec Softec, and Rayner Flex were analyzed. Pairwise comparisons were conducted between AcrySof IOLs and other IOLs using Bonferroni adjustment for multiplicity. Multivariate analyses were conducted adjusting for known confounders. RESULTS The incidence of Nd:YAG capsulotomy ranged between 2.4-12.6% at 3 years and 5.8-19.3% at 5 years post-cataract surgery. Similarly, the incidence of PCO ranged between 4.7-18.6% at 3 years and 7.1-22.6% at 5 years. When comparing all of the single-piece IOLs, AcrySof demonstrated the lowest incidence rates for both PCO and Nd:YAG (P < 0.001 for each comparison). From adjusted logistic regression analysis, AcrySof were associated with lower 3- and 5-year odds of Nd:YAG and PCO incidence. CONCLUSIONS Following cataract surgery with single-piece monofocal IOLs different incidence rates of PCO were observed with different IOLs. AcrySof IOLs were associated with significantly lower incidence of PCO requiring Nd:YAG treatment over periods of 3 and 5 years.
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Zhang J, Hussain A, Yue S, Zhang T, Marshall J. Osmotically induced removal of lens epithelial cells to prevent PCO after pediatric cataract surgery: Pilot study to assess feasibility. J Cataract Refract Surg 2019; 45:1480-1489. [PMID: 31564322 DOI: 10.1016/j.jcrs.2019.04.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 04/19/2019] [Accepted: 04/30/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Development of an osmotic-shock technique to remove human lens epithelial cells (LECs) as a preventive measure to address posterior capsule opacification (PCO) after pediatric cataract surgery. SETTING Department of Genetics, UCL Institute of Ophthalmology, London, England, and Department of Ophthalmology, Ruijin Hospital, Jiao Tong University, Shanghai, China. DESIGN Laboratory study. METHODS Various tissue preparations of human LECs (cultured on coverslips/collagen-coated membrane inserts, human lens capsule biopsies, and lens organ cultured PCO models) were subjected to a single or incremental hyperosmotic shock (NaCl, 350-4000 mOsm/L) in the presence of inhibitors of the Na+-K+-2Cl- cotransporter (NKCC) (to disable the regulatory volume increase [RVI] process). The integrity of the cell monolayer was determined by phase-contrast microscopy, viability assays, and measurement of transepithelial resistance. RESULTS Hyperosmotic shock (400 mOsm/L) caused rapid cell shrinkage (<5 minutes) in all the LEC models studied. In the absence of the NKCC inhibitor, the shrunk cells gradually returned to their original cell volume and architecture over time, while still exposed to the hyperosmotic shock. However, inhibition of the RVI process disabled the ability for restoration of cell volume leading to persistent cell shrinkage, subsequently resulting in cell detachment from the underlying support medium. CONCLUSION Hyperosmotic shock in the presence of inhibitors of the RVI process was effective in rapidly detaching LECs from their basement membranes. This technique could potentially facilitate removal of residual LECs left on the lens capsule after cataract surgery, thus decreasing or eliminating the risk for aggressive cell proliferation and the development of PCO.
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Affiliation(s)
- JinJun Zhang
- Department of Genetics, UCL Institute of Ophthalmology, London, England.
| | - Ali Hussain
- Department of Genetics, UCL Institute of Ophthalmology, London, England
| | - Sun Yue
- Department of Genetics, UCL Institute of Ophthalmology, London, England; Department of Ophthalmology, Ruijin Hospital, Jiao Tong University, Shanghai, China
| | - Tao Zhang
- Department of Genetics, UCL Institute of Ophthalmology, London, England
| | - John Marshall
- Department of Genetics, UCL Institute of Ophthalmology, London, England
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Ahmed SN, Shahid SM, Nanavaty MA. Misdiagnosed opacification of a hydrophobic acrylic intraocular lens. J Cataract Refract Surg 2019; 45:1512-1514. [PMID: 31564324 DOI: 10.1016/j.jcrs.2019.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 07/17/2019] [Accepted: 07/18/2019] [Indexed: 11/30/2022]
Abstract
A 75-year-old woman was referred for decreased visual acuity resulting from "opacification of the IOL" in the immediate period after uneventful bilateral cataract surgery with single-piece AcrySof IQ intraocular lens (IOL) implantation. A neodymium:YAG laser capsulotomy had been performed in both eyes to treat the complication. Anterior segment optical coherence tomography performed at presentation showed an opaque membrane enveloping the IOL. The membrane was peeled from the anterior IOL surface, and all adherences between the IOL and capsular bag were freed. One year later, the eyes remained stable; the uncorrected distance visual acuity was 20/20, the IOL was clear, and there was no evidence of recurrence of the membrane. Appropriate imaging for the diagnosis and surgical peeling with freeing of the adhesions between the IOL and the capsular bag were essential to the success in this case.
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Affiliation(s)
- Syed Naqib Ahmed
- Eastbourne District General Hospital, Eastbourne, United Kingdom; Sussex Eye Hospital, Brighton & Sussex University Hospitals NHS Trust, Brighton, United Kingdom
| | | | - Mayank A Nanavaty
- Sussex Eye Hospital, Brighton & Sussex University Hospitals NHS Trust, Brighton, United Kingdom; Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton, United Kingdom.
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Fang Y, Xixia D, Jin L, Lei L, Pingjun C, Hongfang Z, Yun-E Z. Relationship of Posterior Capsular Opacification and Capsular Bend Type Investigation Based on Swept-source Optical Coherence Tomography. Curr Eye Res 2019; 45:17-23. [PMID: 31348676 DOI: 10.1080/02713683.2019.1645183] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To investigate the relationship between capsular bend type and posterior capsule opacification (PCO) at a three-dimensional (3D) level using high-speed swept-source optical coherence tomography (SS-OCT).Methods: This was a retrospective study. A total of 99 eyes that underwent standard cataract surgery with phacoemulsification 2 years ago were analyzed. Standard SS-OCT radial scanning was performed in all eyes and the obtained photos were used for morphological observations of the capsular bend-IOL complex, the adhesion of posterior capsule to the IOL optic, and the position of the anterior capsulorhexis. Digital retroillumination photographs were taken of the posterior capsule of each eye to evaluate PCO (scoring and area).Results: In terms of the PCO score and area, there was no statistical difference between eyes with complete and incomplete adhesion of posterior capsule to IOL (both P > .05), whereas the partial overlap group showed a statistical difference greater than the total overlap group (P < .05). There were two types of capsular bends, completed adhesion (CA) and incomplete adhesion (IA). IA was divided into funnel adhesion (IA-F), parallel adhesion (IA-P), and detached adhesion (IA-D). The incomplete adhesion index (IAI) varied between eyes and ranged from 0 to 1. The PCO score and area in the high IAI group (higher than 0.50) were significantly greater than the low IAI group (< 0.50) (P < .05). In addition, the PCO score and area were significantly higher in the cohort with at least one IA-D capsular bend in six districts to the group that did not have IA-D capsular bend (P < .05).Conclusions: Complete or incomplete adhesion of the posterior capsule to the IOL optic may not be necessary for the development of PCO. Our study suggests that capsular bend type may be used as an index to predict PCO.
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Affiliation(s)
- Yu Fang
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ding Xixia
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Li Jin
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lin Lei
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chang Pingjun
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhang Hongfang
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhao Yun-E
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Nanavaty MA, Zukaite I, Salvage J. Edge profile of commercially available square-edged intraocular lenses: Part 2. J Cataract Refract Surg 2019; 45:847-853. [PMID: 30929976 DOI: 10.1016/j.jcrs.2018.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 11/27/2018] [Accepted: 12/03/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To analyze the sharpness of the posterior optic edge and edge thickness of intraocular lenses (IOLs) marketed with a square-edged profile. SETTING University of Brighton and Brighton and Sussex University Hospitals NHS Trust, Brighton, England. DESIGN Laboratory study. METHODS Fourteen square-edged 20.0 diopter IOLs were analyzed, including 9 hydrophobic IOLs (AF-1, AF-1 iSert, Clareon, EyeCee One Crystal, CT Lucia, Envista, EyeCee One, Vivinex iSert, and RayOne Hydrophobic) and 5 hydrophilic IOLs (Asphira, CT Asphina, Incise, Synthesis, and RayOne Hydrophilic). All the IOLs were scanned following a previously published standardized technique using environmental scanning electron microscopy. The posterior optic edges were scanned at a magnification of ×500 and ×200 to measure the radius of curvature of the posterior optic edges and the optic edge thickness. RESULTS The radius of curvature of the posterior optic edges ranged from 4.6 to 20.6 μm. Except for the Incise IOL (7.7 μm), all hydrophilic IOLs (Synthesis [10.6 μm], Asphira [13.7 μm], RayOne Hydrophilic [14.0 μm], CT Asphina [13.7 μm]) had a radius of curvature greater than 10.0 μm. For the hydrophobic IOLs, the radius of curvature was less than 10.0 μm for the Clareon (7.9 μm), EyeCee One Crystal (4.7 μm), Vivinex iSert (7.6 μm), and CT Lucia (4.6 μm), and greater than 10.0 μm for the Envista (19.7 μm), EyeCee One (13.7 μm), AF-1 iSert (19.7 μm), AF-1 (19.7 μm) and the RayOne Hydrophobic (20.6 μm). The Vivinex iSert (150.5 μm) and the Incise (218.2 μm) were the thinnest IOLs, and the RayOne Hydrophobic (375.8 μm) and RayOne Hydrophilic IOLs (477.1 μm) were the thickest of the hydrophobic and hydrophilic IOLs, respectively. CONCLUSIONS Commercially marketed square-edged IOLs still differed in the sharpness of the posterior optic edge. More hydrophobic IOLs have rounder edges than those studied 10 years ago. Variations in the edge profile of hydrophobic IOLs were greater compared with the hydrophilic IOLs.
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Affiliation(s)
- Mayank A Nanavaty
- Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, England; Brighton and Sussex Medical School, University of Sussex, Falmer, England.
| | - Ieva Zukaite
- Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, England; Medical Faculty, Otto von Guericke University, Magdeburg, Germany
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Lytvynchuk LM, Glittenberg CG, Falkner-Radler CI, Neumaier-Ammerer B, Smretschnig E, Hagen S, Ansari-Shahrezaei S, Binder S. Evaluation of intraocular lens position during phacoemulsification using intraoperative spectral-domain optical coherence tomography. J Cataract Refract Surg 2018; 42:694-702. [PMID: 27255245 DOI: 10.1016/j.jcrs.2016.01.044] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 01/04/2016] [Accepted: 01/26/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the position of intraocular lenses (IOLs) at the end of standard phacoemulsification with intraoperative spectral-domain optical coherence tomography (SD-OCT). SETTINGS Department of Ophthalmology, Rudolf Foundation Hospital, Vienna, Austria. DESIGN Prospective case series. METHODS Standard phacoemulsification with IOL implantation was performed. The Rescan 700 SD-OCT system was used for intraoperative imaging. The anterior segment of the eye was scanned using SD-OCT at the end of the surgery. The distance from the IOL optic center and the IOL optic edge to the posterior capsule was measured postoperatively using graphic software. RESULTS The study comprised 74 patients (101 eyes). The mean axial length was 23.97 mm (range 21.43 to 28.61 mm). The mean IOL power was 20.39 diopters (D) (range 6.5 to 27.5 D). Contact between the IOL and posterior capsule was absent in 88 cases (87.13%), and partial or full contact was present in 13 cases (12.87%). The mean distance between the IOL central optic and posterior capsule was 0.71 pixel (range 0.06 to 1.38 pixels) in 99 cases (98.02%). In 42 cases (57.53%), partial contact between the IOL edges and the posterior capsule was noticed. The mean distance between the IOL edge and posterior capsule was 0.21 pixel (range 0.04 to 0.92 pixel). CONCLUSIONS Intraoperative SD-OCT facilitated the imaging of IOL position during standard phacoemulsification. Contact between the IOL central optic and posterior capsule at the end of the surgery occurred rarely. Improved IOL design should be considered. FINANCIAL DISCLOSURE Drs. Binder and Glittenberg are consultants to Carl Zeiss Meditech AG. None of the other authors has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Lyubomyr M Lytvynchuk
- From the Department of Ophthalmology (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), Rudolf Foundation Hospital, the Karl Landsteiner Institute for Retinal Research and Imaging (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), and the Retina Center (Ansari-Shahrezaei, Binder), Vienna, and the Department of Ophthalmology (Ansari-Shahrezaei), Medical University of Graz, Graz, Austria; the Ophthalmology Department (Lytvynchuk), University Clinic Gießen and Marburg GmbH, Gießen, Germany; the Professor Sergienko Eye Clinic (Lytvynchuk), Vinnytsia, Ukraine.
| | - Carl G Glittenberg
- From the Department of Ophthalmology (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), Rudolf Foundation Hospital, the Karl Landsteiner Institute for Retinal Research and Imaging (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), and the Retina Center (Ansari-Shahrezaei, Binder), Vienna, and the Department of Ophthalmology (Ansari-Shahrezaei), Medical University of Graz, Graz, Austria; the Ophthalmology Department (Lytvynchuk), University Clinic Gießen and Marburg GmbH, Gießen, Germany; the Professor Sergienko Eye Clinic (Lytvynchuk), Vinnytsia, Ukraine
| | - Christiane I Falkner-Radler
- From the Department of Ophthalmology (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), Rudolf Foundation Hospital, the Karl Landsteiner Institute for Retinal Research and Imaging (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), and the Retina Center (Ansari-Shahrezaei, Binder), Vienna, and the Department of Ophthalmology (Ansari-Shahrezaei), Medical University of Graz, Graz, Austria; the Ophthalmology Department (Lytvynchuk), University Clinic Gießen and Marburg GmbH, Gießen, Germany; the Professor Sergienko Eye Clinic (Lytvynchuk), Vinnytsia, Ukraine
| | - Beatrix Neumaier-Ammerer
- From the Department of Ophthalmology (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), Rudolf Foundation Hospital, the Karl Landsteiner Institute for Retinal Research and Imaging (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), and the Retina Center (Ansari-Shahrezaei, Binder), Vienna, and the Department of Ophthalmology (Ansari-Shahrezaei), Medical University of Graz, Graz, Austria; the Ophthalmology Department (Lytvynchuk), University Clinic Gießen and Marburg GmbH, Gießen, Germany; the Professor Sergienko Eye Clinic (Lytvynchuk), Vinnytsia, Ukraine
| | - Eva Smretschnig
- From the Department of Ophthalmology (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), Rudolf Foundation Hospital, the Karl Landsteiner Institute for Retinal Research and Imaging (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), and the Retina Center (Ansari-Shahrezaei, Binder), Vienna, and the Department of Ophthalmology (Ansari-Shahrezaei), Medical University of Graz, Graz, Austria; the Ophthalmology Department (Lytvynchuk), University Clinic Gießen and Marburg GmbH, Gießen, Germany; the Professor Sergienko Eye Clinic (Lytvynchuk), Vinnytsia, Ukraine
| | - Stefan Hagen
- From the Department of Ophthalmology (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), Rudolf Foundation Hospital, the Karl Landsteiner Institute for Retinal Research and Imaging (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), and the Retina Center (Ansari-Shahrezaei, Binder), Vienna, and the Department of Ophthalmology (Ansari-Shahrezaei), Medical University of Graz, Graz, Austria; the Ophthalmology Department (Lytvynchuk), University Clinic Gießen and Marburg GmbH, Gießen, Germany; the Professor Sergienko Eye Clinic (Lytvynchuk), Vinnytsia, Ukraine
| | - Siamak Ansari-Shahrezaei
- From the Department of Ophthalmology (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), Rudolf Foundation Hospital, the Karl Landsteiner Institute for Retinal Research and Imaging (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), and the Retina Center (Ansari-Shahrezaei, Binder), Vienna, and the Department of Ophthalmology (Ansari-Shahrezaei), Medical University of Graz, Graz, Austria; the Ophthalmology Department (Lytvynchuk), University Clinic Gießen and Marburg GmbH, Gießen, Germany; the Professor Sergienko Eye Clinic (Lytvynchuk), Vinnytsia, Ukraine
| | - Susanne Binder
- From the Department of Ophthalmology (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), Rudolf Foundation Hospital, the Karl Landsteiner Institute for Retinal Research and Imaging (Lytvynchuk, Glittenberg, Falkner-Radler, Neumaier-Ammerer, Smretschnig, Hagen, Ansari-Shahrezaei, Binder), and the Retina Center (Ansari-Shahrezaei, Binder), Vienna, and the Department of Ophthalmology (Ansari-Shahrezaei), Medical University of Graz, Graz, Austria; the Ophthalmology Department (Lytvynchuk), University Clinic Gießen and Marburg GmbH, Gießen, Germany; the Professor Sergienko Eye Clinic (Lytvynchuk), Vinnytsia, Ukraine
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Zeng L, Fang F. Advances and challenges of intraocular lens design [Invited]. APPLIED OPTICS 2018; 57:7363-7376. [PMID: 30182957 DOI: 10.1364/ao.57.007363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/29/2018] [Indexed: 06/08/2023]
Abstract
Phacoemulsification technique with intraocular lens implantation has been a common treatment for cataract patients. With rising demand among the public, new technologies for lens design have emerged to minimize intraocular aberrations, improving visual quality to the largest extent. This paper systematically reviews the development of materials applied in lens manufacturing, the different categories of intraocular lenses, and respective design principles. The advantages and potential drawbacks of intraocular lenses are illustrated in the paper, and prospective research to improve the design are presented in the end.
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Biomaterial Influence on Intraocular Lens Performance: An Overview. J Ophthalmol 2018; 2018:2687385. [PMID: 29736282 PMCID: PMC5874989 DOI: 10.1155/2018/2687385] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 12/08/2017] [Accepted: 01/02/2018] [Indexed: 11/18/2022] Open
Abstract
There is strong evidence that the IOL material is the factor having the greatest impact on posterior capsule opacification (PCO), anterior capsule opacification (ACO) development, and glistening formation after cataract surgery, even though there are other IOL features—such as haptic material and design and edge and optic design—that also have some influence. We reviewed the published literature describing the adverse events that are mainly related to the intraocular lens (IOL) material, such as PCO, ACO, and the subsequent capsule contraction, as well as glistening formation. The adverse events presented in this overview are the most common ones in clinical practice, and therefore, they are generally included in the clinical protocols for IOL evaluation.
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Tortolano L, Saunier J, Hammami S, Manerlax K, Matmati H, Do B, Jubeli E, Fattal E, Yagoubi N. Restructuration kinetics of amphiphilic intraocular lenses during aging. Colloids Surf B Biointerfaces 2018; 161:420-432. [PMID: 29121615 DOI: 10.1016/j.colsurfb.2017.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/11/2017] [Accepted: 11/02/2017] [Indexed: 12/11/2022]
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Reply. Ophthalmology 2017; 124:e81-e82. [DOI: 10.1016/j.ophtha.2017.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 05/19/2017] [Indexed: 11/20/2022] Open
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Schojai M, Schultz T, Haeussler-Sinangin Y, Boecker J, Dick BH. Safety of femtosecond laser–assisted primary posterior capsulotomy immediately after cataract surgery. J Cataract Refract Surg 2017; 43:1171-1176. [DOI: 10.1016/j.jcrs.2017.06.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/19/2017] [Accepted: 06/27/2017] [Indexed: 10/18/2022]
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Long-term Posterior Capsule Opacification Reduction with Square-Edge Polymethylmethacrylate Intraocular Lens. Ophthalmology 2017; 124:295-302. [DOI: 10.1016/j.ophtha.2016.11.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/24/2016] [Accepted: 11/09/2016] [Indexed: 11/30/2022] Open
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Kalauz M, Masnec S, Kordić R, Kuzman T, Vidas S, Škegro I, Jandroković S, Perić S. Posterior Capsule Opacification and Nd:YAG Rates with Two Acrylic Intraocular Lenses after Age-Related Cataract Treatment: Three-year Results. Semin Ophthalmol 2016; 33:395-401. [DOI: 10.1080/08820538.2016.1247182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Miro Kalauz
- Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
- University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Sanja Masnec
- Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
- University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Rajko Kordić
- Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
- University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Tomislav Kuzman
- Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
- University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Sania Vidas
- Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Ivan Škegro
- Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Sonja Jandroković
- Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Sanja Perić
- Department of Ophthalmology, Zagreb University Hospital Centre, Zagreb, Croatia
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Zhu X, He W, Yang J, Hooi M, Dai J, Lu Y. Adhesion of the posterior capsule to different intraocular lenses following cataract surgery. Acta Ophthalmol 2016; 94:e16-25. [PMID: 25899313 DOI: 10.1111/aos.12739] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 03/18/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the prevalence and morphologic and clinical features of posterior capsule-optic inadhesion following cataract surgery. METHODS In this prospective cohort study, we examined 518 consecutive patients who had undergone uneventful phacoemulsification and posterior chamber intraocular lens (IOL) implantation. They were assigned into five groups based on the type of IOL used: MC X11 ASP, Rayner 920H A, ZCB00, SN60WF and KS-3Ai. Routine ophthalmic examinations were performed. Patients were followed up at 1 day, 1 week, and 1 and 2 months postsurgery. Anterior segment photography, Scheimpflug imaging and KR-1W aberrometry were conducted after the patients' pupils were dilated. RESULTS The overall rate of posterior capsule-optic inadhesion on the first day after surgery was 215/518 (41.5%), and it decreased to 37/518 (7.1%) at 2 months postsurgery. Posterior capsule-optic inadhesion can be morphologically classified into five types with three outcomes, of which gradual absorption of the accumulated fluid predominated for all IOLs. The clinical characteristics of patients with inadhesion varied with IOL type. Notably, visual quality data (Strehl ratios and modulation transfer function) were poorer in patients with posterior capsule-optic inadhesion, especially in those with irregular forms of suspension. Four cases of capsular contraction syndrome were identified among the patients with inadhesion. CONCLUSIONS Posterior capsule-optic inadhesion is a prevalent capsule-IOL interaction following cataract surgery. Although the accumulated fluid is absorbed in the majority of patients, its adverse effects on visual outcomes, especially visual quality in the operated eye(s), must not be underestimated in patients with persistent inadhesion.
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Affiliation(s)
- Xiangjia Zhu
- Department of Ophthalmology; Eye and Ear, Nose and Throat Hospital; Fudan University; Shanghai China
- Key Laboratory of Myopia; Ministry of Health; Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration; Fudan University; Shanghai China
| | - Wenwen He
- Department of Ophthalmology; Eye and Ear, Nose and Throat Hospital; Fudan University; Shanghai China
- Key Laboratory of Myopia; Ministry of Health; Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration; Fudan University; Shanghai China
| | - Jin Yang
- Department of Ophthalmology; Eye and Ear, Nose and Throat Hospital; Fudan University; Shanghai China
- Key Laboratory of Myopia; Ministry of Health; Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration; Fudan University; Shanghai China
| | - Michelle Hooi
- University of Adelaide; Adelaide South Australia Australia
| | - Jinhui Dai
- Department of Ophthalmology; Eye and Ear, Nose and Throat Hospital; Fudan University; Shanghai China
- Key Laboratory of Myopia; Ministry of Health; Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration; Fudan University; Shanghai China
| | - Yi Lu
- Department of Ophthalmology; Eye and Ear, Nose and Throat Hospital; Fudan University; Shanghai China
- Key Laboratory of Myopia; Ministry of Health; Shanghai China
- Shanghai Key Laboratory of Visual Impairment and Restoration; Fudan University; Shanghai China
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Comparison of Manual, Femtosecond Laser, and Precision Pulse Capsulotomy Edge Tear Strength in Paired Human Cadaver Eyes. Ophthalmology 2015; 123:265-274. [PMID: 26707416 DOI: 10.1016/j.ophtha.2015.10.019] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 10/07/2015] [Accepted: 10/10/2015] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To compare the anterior lens capsulotomy edge tear strength created by manual continuous curvilinear capsulorhexis (CCC), femtosecond laser capsulotomy (FSLC), and a new automated precision pulse capsulotomy (PPC) device. DESIGN A 3-arm study in paired human cadaver eyes. PARTICIPANTS A total of 44 eye specimens from 22 donors in the United States. METHODS Capsulotomy was performed in all eye specimens using manual CCC, a femtosecond laser (LenSx, Alcon, Fort Worth, TX), or an automated PPC device (Zepto, Mynosys Inc., Fremont, CA). The first study arm consisted of 8 pairs of eyes in which 1 eye received PPC and the fellow eye received FSLC. The second study arm consisted of 8 pairs of eyes, with 1 eye receiving PPC and the fellow eye receiving manual CCC. The third study arm consisted of 6 pairs of eyes, with 1 eye receiving a manual CCC and the fellow eye receiving FSLC. After phacoemulsification, 2 capsulotomy edge retractors attached to force transducers were used to stretch the capsulotomy edge of each eye and to measure the resisting force until the capsulotomy edge was torn. MAIN OUTCOME MEASURES Capsulotomy edge tear strength in millinewtons. RESULTS The PPC edge tear strength was greater than that of FSLC for all 8 pairs of eyes by an average factor of 3.1-fold (PPC mean 73.3±24.9 mN vs. femtosecond laser mean 26.1±6.8 mN; P = 0.012, Wilcoxon matched-pairs, signed-ranks test). The PPC tear strength was greater than that of manual CCC for all 8 pairs of eyes by an average factor of 4.1-fold (PPC mean 95±35.2 mN vs. manual CCC mean 29.1±23.1 mN; P = 0.012, Wilcoxon matched-pairs signed-ranks test). There was no significant difference in the tear strength of capsulotomies produced by manual CCC (mean 21.3±4.9 mN) and FSLC (mean 24.5±11.4 mN) (P = 0.75, Wilcoxon matched-pairs signed-ranks test). CONCLUSIONS The strength of the PPC capsulotomy edge was significantly stronger than that produced by femtosecond laser or manual CCC.
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Stepanov A, Nekolova J, Jiraskova N, Rozsival P. Long-term follow-up of posterior capsule opacification after AquaLase and NeoSoniX phacoemulsification. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2015; 160:143-8. [PMID: 26365930 DOI: 10.5507/bp.2015.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 07/23/2015] [Indexed: 11/23/2022] Open
Abstract
AIM To compare the degree of posterior capsule opacification (PCO) after AquaLase and NeoSoniX phacoemulsification methods during an 8-year follow-up period using two types of software. DESIGN Prospective, randomized clinical trial. METHODS AquaLase was used in the right eye and NeoSoniX in the left eye of each patient with bilateral cataract. RESULTS Fifty patients were analyzed 1 year, 46 patients 3 years, and 37 patients 8 years after cataract surgery. Mean EPCO 2000 values were for the AquaLase group 0.324 ± 0.305 and for the NeoSoniX group 0.298 ± 0.341 (P = 0.53) 1 year after surgery, for the AquaLase group 0.582 ± 0.506 and for the NeoSoniX group 0.594 ± 0.515 (P = 0.87) 3 years after surgery, and for the AquaLase group 0.648 ± 0.567 and for the NeoSoniX group 0.673 ± 0.542 (P = 0.30) 8 years after surgery. The OSCA results were for the AquaLase group 0.7097 ± 0.3778 and for the NeoSoniX group 0.8584 ± 0.4323 (P = 0.046) 1 year after surgery, for the AquaLase group 0.9667 ± 0.736 and for the NeoSoniX group 0.9540 ± 0.5250 (P = 0.91) 3 years after surgery, and for the AquaLase group 1,035 ± 0,952 and for the NeoSoniX group 1,103 ± 0,741 (P = 0.44) 8 years after surgery. CONCLUSION There was minimal PCO difference between these 2 approaches, AquaLase and NeoSoniX. Neither AquaLase nor NeoSoniX technique was able to prevent a natural progression of PCO.
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Affiliation(s)
- Alexandr Stepanov
- Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic
| | - Jana Nekolova
- Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic
| | - Nada Jiraskova
- Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic
| | - Pavel Rozsival
- Department of Ophthalmology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic
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Packer M, Teuma EV, Glasser A, Bott S. Defining the ideal femtosecond laser capsulotomy. Br J Ophthalmol 2015; 99:1137-42. [PMID: 25829488 PMCID: PMC4518749 DOI: 10.1136/bjophthalmol-2014-306065] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 03/09/2015] [Indexed: 11/23/2022]
Abstract
Purpose We define the ideal anterior capsulotomy through consideration of capsular histology and biomechanics. Desirable qualities include preventing posterior capsular opacification (PCO), maintaining effective lens position (ELP) and optimising capsular strength. Methods Laboratory study of capsular biomechanics and literature review of histology and published clinical results. Results Parameters of ideal capsulotomy construction include complete overlap of the intraocular lens to prevent PCO, centration on the clinical approximation of the optical axis of the lens to ensure concentricity with the capsule equator, and maximal capsular thickness at the capsulotomy edge to maintain integrity. Conclusions Constructing the capsulotomy centred on the clinical approximation of the optical axis of the lens with diameter 5.25 mm optimises prevention of PCO, consistency of ELP and capsular strength.
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Affiliation(s)
- Mark Packer
- Oregon Health & Science University, Eugene, Oregon, USA
| | | | - Adrian Glasser
- College of Optometry, University of Houston, Houston, USA
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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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Mencucci R, Favuzza E, Boccalini C, Gicquel JJ, Raimondi L. Square-edge intraocular lenses and epithelial lens cell proliferation: implications on posterior capsule opacification in an in vitro model. BMC Ophthalmol 2015; 15:5. [PMID: 25599704 PMCID: PMC4324805 DOI: 10.1186/1471-2415-15-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 01/10/2015] [Indexed: 11/26/2022] Open
Abstract
Background To evaluate lens epithelial cell (LEC) proliferation with two different designs (one-piece or three-piece) of hydrophobic acrylic IOLs with 360° square optic edge using an in vitro culture model of posterior capsule opacification (PCO). Methods This experimental study was conducted at the Department of NEUROFARBA, Section of Pharmacology, University of Florence, Italy. Human LECs were seeded and cultured in transwell cell culture inserts coated with a type-IV collagen membrane on which an IOL (one-piece Tecnis-1 or three-piece AR40E, Abbott Medical Optics Inc.) had been previously placed. As control, cells were plated on the insert membrane without an IOL. At day six (cells confluent in controls) IOLs were removed and cell counting, viability and cell density under and outside the IOLs were evaluated. Results No statistically significant difference in the number of cells (p > 0.05) between inserts with the one-piece and three-piece IOLs was found. Cell density in the area under each IOL was significantly lower than in the area outside of it (p < 0.05), or in the control insert. (p < 0.05). Cell density under the single-piece IOL was not significantly different from that under the three-piece IOL (p > 0.05). Conclusions A 360° sharp-edge played a crucial role in avoiding LEC migration under the IOL and preventing the formation of PCO after cataract surgery. Long term clinical evaluation is necessary to estimate functional results.
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Affiliation(s)
- Rita Mencucci
- Department of Surgery and Translational Medicine - Eye Clinic, University of Florence, Florence, Italy.
| | - Eleonora Favuzza
- Department of Surgery and Translational Medicine - Eye Clinic, University of Florence, Florence, Italy.
| | - Carlotta Boccalini
- Department of Surgery and Translational Medicine - Eye Clinic, University of Florence, Florence, Italy.
| | - Jean-Jacques Gicquel
- Department of Ophthalmology, Poitiers University Hospital, Poitiers, Cedex, France.
| | - Laura Raimondi
- Department of NEUROFARBA, section of Pharmacology, University of Florence, Florence, Italy.
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Kim EY, Kim SY, Lee YC, Kim SY. Incidence and Risk Factors of Nd:YAG Capsulotomy in Adult Cataract Patients under 50 Years of Age According to Different Age Groups. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.6.868] [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)
- Eun Yeong Kim
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sun Young Kim
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Chun Lee
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Su Young Kim
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Fischer MC, Meyer-Lindenberg A. [Cataracts in dogs--overview and guideline for decision making in treatment]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2014; 42:411-23; quiz 424. [PMID: 25422865 DOI: 10.15654/tpk-140877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 11/05/2014] [Indexed: 11/13/2022]
Abstract
Cataract is the leading cause of impaired vision and vision loss in dogs. Because of the considerable progress in cataract surgery in recent decades, lens opacities can now be operated on with very good short-term success (90-95%), taking into account that proper patient selection is essential to maximize the probability of a successful surgical outcome. Following a description of anatomical and physiological lens characteristics, the etiology and complications of untreated cataracts are discussed. Furthermore, specific criteria for patient selection are addressed while delineating essential steps of the examination. This article aims to aid decision making in cataract therapy on the basis of diagnostic guidance and to facilitate the selection of an appropriate point of time for surgery.
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Affiliation(s)
- M-C Fischer
- Maria-Christine Fischer, Chirurgische und Gynäkologische Kleintierklinik der Ludwig-Maximilians-Universität München, Veterinärstraße 13, 80539 München, E-Mail:
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Bertrand V, Bozukova D, Lanero TS, Huang YS, Schol D, Rosière N, Grauwels M, Duwez AS, Jérôme C, Pagnoulle C, De Pauw E, De Pauw-Gillet MC. Biointerface multiparametric study of intraocular lens acrylic materials. J Cataract Refract Surg 2014; 40:1536-44. [DOI: 10.1016/j.jcrs.2014.01.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 01/21/2014] [Accepted: 01/21/2014] [Indexed: 10/24/2022]
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Posterior capsule opacification and neodymium:YAG rates with 2 single-piece hydrophobic acrylic intraocular lenses: three-year results. J Cataract Refract Surg 2014; 39:1886-92. [PMID: 24427796 DOI: 10.1016/j.jcrs.2013.06.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To compare the incidence and intensity of posterior capsule opacification (PCO) between 2 similar 1-piece foldable hydrophobic acrylic intraocular lenses (IOLs) over 3 years. SETTING Department of Ophthalmology, Medical University Vienna, Vienna, Austria. DESIGN Randomized prospective patient- and examiner-masked clinical trial with intraindividual comparison. METHODS Patients with bilateral age-related cataract had cataract surgery and implantation of a Tecnis ZCB00 continuous-optic-edge IOL in 1 eye and an Acrysof SA60AT interrupted-optic-edge IOL in the other eye. Postoperative examinations were performed at 6 months and 3 years. Digital retroillumination images were taken of each eye. The amount of PCO (score 0 to 10) was assessed subjectively at the slitlamp and objectively using automated image-analysis software. RESULTS The study comprised 54 patients (108 eyes). The mean objective PCO score was 1.3 ± 1.7 (SD) for the continuous-optic-edge IOLs and 0.9 ± 1.3 for the interrupted-optic-edge IOLs (P=.10). Three years postoperatively, a neodymium:YAG (Nd:YAG) capsulotomy was performed in 26.1% of eyes with the continuous-optic-edge IOL and 21.7% with the interrupted-optic-edge IOL (P=.56). There was no significant difference in corrected distance visual acuity, capsulorhexis–IOL overlap, capsule folds, or anterior capsule opacification 3 years after surgery. CONCLUSIONS Both IOLs had comparable PCO and Nd:YAG rates 3 years postoperatively. The optimized barrier function of the continuous-optic-edge IOL and the material properties of the interrupted-optic-edge IOL seemingly outbalanced the effect on lens epithelial cell migration and proliferation beneath the optic.
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Dick HB, Schultz T. Primary Posterior Laser-Assisted Capsulotomy. J Refract Surg 2014; 30:128-33. [DOI: 10.3928/1081597x-20140120-09] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 11/11/2013] [Indexed: 11/20/2022]
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Vasavada AR, Raj SM, Shah GD, Nanavaty MA. Posterior capsule opacification after lens implantation: incidence, risk factors and management. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/eop.12.80] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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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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Kim JA, Ha AN, Kwon JW, Wee WR, Han YK. Clinical Characteristics and Patient's Satisfaction in Pseudophakic Negative Dysphotopsia. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2014. [DOI: 10.3341/jkos.2014.55.5.669] [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)
- Jeong Ah Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Corneal Regenerative Medicine and Ocular Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| | - Ah Nul Ha
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Corneal Regenerative Medicine and Ocular Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| | - Ji Won Kwon
- Department of Ophthalmology, Myongji Hospital, Kwandong University College of Medicine, Goyang, Korea
| | - Won Ryang Wee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Corneal Regenerative Medicine and Ocular Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| | - Young Keun Han
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
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Morgan-Warren PJ, Smith JA. Intraocular lens-edge design and material factors contributing to posterior-capsulotomy rates: comparing Hoya FY60aD, PY60aD, and AcrySof SN60WF. Clin Ophthalmol 2013; 7:1661-7. [PMID: 24003302 PMCID: PMC3755701 DOI: 10.2147/opth.s48824] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To compare neodymium-doped yttrium aluminum garnet laser posterior capsulotomy (LPC) rates between the Hoya FY60AD, Hoya PY60AD, and Alcon AcrySof SN60WF intraocular lenses (IOLs) after routine cataract surgery. METHODS In this retrospective comparative study, patients undergoing uncomplicated cataract surgery over a 3-year period were included, and those subsequently undergoing LPC were identified from laser clinic records. LPC rates at 2 years postoperatively were compared between the round-edged Hoya FY60AD, the newer sharp-edged Hoya PY60AD three-piece IOLs, and the one-piece AcrySof SN60WF IOL. RESULTS A total of 1,265 cataract operations were included, and 49 eyes (3.9%) underwent LPC within 2 years of surgery. Twenty-eight of 315 eyes (8.9%) implanted with the FY60AD underwent LPC by 2 years, compared to eleven of 254 (4.3%) with the newer sharp square-edged PY60AD and ten of 696 (1.4%) with the one-piece SN60WF (P < 0.05, Chi-squared analyses). CONCLUSIONS The newer, sharper-edged Hoya PY60AD IOL has a lower LPC rate than the Hoya FY60AD IOL at 2 years post-cataract surgery. The one-piece AcrySof SN60WF has a lower LPC rate than both the three-piece Hoya IOLs in the same time period postoperatively. Variations in IOL-edge design and material effect may have contributed to the different rates observed.
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Interleukin-6 in the pathogenesis of posterior capsule opacification and the potential role for interleukin-6 inhibition in the future of cataract surgery. Med Hypotheses 2013; 80:466-74. [DOI: 10.1016/j.mehy.2012.12.042] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 07/18/2012] [Accepted: 12/29/2012] [Indexed: 12/14/2022]
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Chang A, Behndig A, Rønbeck M, Kugelberg M. Comparison of posterior capsule opacification and glistenings with 2 hydrophobic acrylic intraocular lenses: 5- to 7-year follow-up. J Cataract Refract Surg 2013; 39:694-8. [PMID: 23499068 DOI: 10.1016/j.jcrs.2012.11.032] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 11/27/2012] [Accepted: 11/28/2012] [Indexed: 11/17/2022]
Abstract
PURPOSE To compare posterior capsule opacification (PCO) and glistenings 5 to 7 years after cataract surgery with implantation of 2 hydrophobic acrylic intraocular lenses (IOLs) and evaluate the effects on corrected distance visual acuity (CDVA) and contrast sensitivity. SETTING St. Erik Eye Hospital, Stockholm, Sweden. DESIGN Randomized clinical trial. METHODS Cataract surgery with standard phacoemulsification was performed in 1 eye of patients. The patients were randomized to an Acrysof SA60AT (1-piece IOL group) or a Sensar AR40e (3-piece IOL group), both hydrophobic acrylic IOLs with a sharp-edged design. Five to 7 years postoperatively, retroillumination images were obtained and the PCO area and severity (area affected within the capsulorhexis and severity) were evaluated using computer software. High-contrast (100%) and low-contrast (2.5%) CDVAs were measured. The neodymium:YAG laser capsulotomy rates were recorded. Scheimpflug images were obtained to evaluate glistenings, which were graded subjectively at the slitlamp and quantified objectively by digital image analysis using computer software. RESULTS The study enrolled 80 patients. There were no significant differences in PCO between the 2 groups. The 3-piece IOL group had significantly fewer glistenings (P<.001). There was good correlation between the subjective grading of glistenings and objective computer-processed image grading. The glistenings were not correlated with IOL power, CDVA, or contrast sensitivity. CONCLUSIONS There were no significant differences in PCO between the 2 acrylic hydrophobic IOLs 5 to 7 years postoperatively. The 1-piece IOL group developed more glistenings than the 3-piece IOL group.
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Affiliation(s)
- Anthony Chang
- St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
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Zhao Y, Li J, Lu W, Chang P, Lu P, Yu F, Xing X, Ding X, Lu F, Zhao Y. Capsular adhesion to intraocular lens in highly myopic eyes evaluated in vivo using ultralong-scan-depth optical coherence tomography. Am J Ophthalmol 2013; 155:484-491.e1. [PMID: 23218694 DOI: 10.1016/j.ajo.2012.08.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 08/28/2012] [Accepted: 08/28/2012] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the in vivo capsular apposition to the intraocular lens (IOL) in subjects with high myopia by ultralong-scan-depth optical coherence tomography (OCT). DESIGN Prospective observational case series. METHODS Forty eyes from 40 cataract patients scheduled for phacoemulsification surgery at the Affiliated Eye Hospital, Wenzhou Medical College were studied, of which 20 eyes were highly myopic (axial length >26 mm) and 20 eyes were emmetropic (22 mm < axial length <24.5 mm). All eyes were examined with a custom-built ultralong-scan-depth OCT at 4 hours, 1 day, 7 days, 14 days, and 28 days after surgery. RESULTS Anterior capsule contact with the IOL was significantly delayed in highly myopic eyes. Complete apposition of the posterior capsule with the IOL was significantly less common among highly myopic eyes than in emmetropic eyes (4 vs 16 eyes; P = .001). Posterior capsule adhesion to the IOL was inversely correlated with axial length (r = -0.494, P < .001, nonparametric Spearman test). The 3 types of complete adhesive capsular bend configurations observed were classified as anterior adhesion, middle adhesion, and posterior adhesion. Incomplete adhesion patterns were classified as funnel adhesion, parallel adhesion, and furcate adhesion. Five highly myopic eyes had slight posterior capsule opacification (PCO) at the last follow-up, as did 1 emmetropic eye. CONCLUSIONS Ultralong-scan-depth OCT revealed weak capsular adhesion and incompletely adhesive types of capsular bend in highly myopic eyes. These features presumably increase the likelihood of PCO during the early postoperative period.
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Affiliation(s)
- Yinying Zhao
- School of Ophthalmology and Optometry and Affiliated Eye Hospital, Wenzhou Medical College, Wenzhou, Zhejiang, China
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Wang Y, Li W, Wang Y, Huang Y. Growth inhibition of human lens epithelial cells by short hairpin RNA in transcription factor forkhead box E3 (FOXE3). Graefes Arch Clin Exp Ophthalmol 2012; 250:999-1007. [PMID: 22527307 DOI: 10.1007/s00417-012-1944-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 01/19/2012] [Accepted: 01/24/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Posterior capsule opacification occurs mainly due to the remnant lens epithelial cell proliferation and migration after cataract surgery. The purpose of this study was to investigate whether small hairpin RNA (shRNA)-mediated gene silencing of transcription factor forkhead box E3 (FOXE3) can be employed to inhibit the expression of FOXE3 and suppress the growth in lens epithelial cells. METHODS FOXE3-targeted shRNA was transfected into a human lens epithelial cell line (HLEB-3) using Lipofectamine 2000 reagent. Quantitative PCR was used to confirm the downregulation of FOXE3 mRNA expression following infection of lens epithelial cells, and FOXE3 protein expression levels were evaluated by Western blot analysis and immunofluorescence staining. HLEB-3 cell growth after the transduction was analyzed by cell counting and MTT colorimetric assay. Cell cycle of the HLEB-3 cells was examined by flowcytometric analysis. RESULTS Compared with the control groups, both mRNA and protein levels of FOXE3 expression were significantly decreased in shRNA-treated groups, and cytostatic effects were obvious within 48 h after transfection. An increased incidence of G1-phase arrest was identified in FOXE3-shRNA transfected HLEB-3 cells. CONCLUSIONS shRNA-mediated gene silencing of FOXE3 could significantly inhibit cell growth and induce the G1-phase arrest in HLEB-3 cells. Formation of posterior capsular opacification might be repressed if lens epithelial cell growth ceases after the FOXE3 gene is silenced with molecular biology technology.
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Affiliation(s)
- Ye Wang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong Academy of Medical Sciences, Qingdao, China
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Nanavaty MA, Spalton DJ, Gala KB, Dhital A, Boyce J. Effect of intraocular lens asphericity on posterior capsule opacification between two intraocular lenses with same acrylic material: a fellow-eye study. Acta Ophthalmol 2012; 90:e104-8. [PMID: 22067557 DOI: 10.1111/j.1755-3768.2011.02286.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate intra-individual differences in posterior capsule opacification (PCO) and visual performance between spherical AcrySof SN60AT and an aspheric AcrySof SN60WF intraocular lens (IOL) with a posterior aspheric surface, both of which are made of same hydrophobic acrylic material. SETTING Ophthalmology Department, St Thomas' Hospital, London, UK. METHODS In this prospective randomized, fellow-eye comparison, an aspheric IOL, which is 9% thinner in comparison with the spherical IOL, was randomized to the first eye of 47 patients and fellow-eye surgery was performed within 3 weeks. Follow-up was at 1, 3, 6, 12 and 24 months. Corrected logMAR visual acuity (CDVA) was measured at 100% and 9% contrast. After pupil dilation, digital retroillumination photographs were taken and the mean PCO percentage was calculated using poco software at each follow-up visit. RESULTS At 1, 3, 6, 12 and 24 months, 47 (94 eyes), 44 (88 eyes), 42 (84 eyes) and 41 (82 eyes) patients were followed-up respectively. Hundred per cent and 9% of LogMAR CDVA was not significantly different between the two IOLs (p = NS at all time-points). Percentage area PCO scores (mean ± SD) at 1, 3, 6, 12 and 24 months with the spherical IOL was 5.82 ± 9.89, 7.76 ± 16.83, 7.21 ± 12.46, 9.29 ± 18.25 and 14.39 ± 25.42, respectively, and with an aspheric IOL was 8.91 ± 12.79, 5.97 ± 10.32, 5.15 ± 7.92, 7.68 ± 11.18 and 12.18 ± 20.10, respectively (p = NS at all time-points). CONCLUSIONS Posterior capsule opacification was not significantly different between the spheric and aspheric IOLs in this fellow-eye, randomized comparison. Additional asphericity on the existing model of IOL does not influence PCO performance.
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Affiliation(s)
- Mayank A Nanavaty
- Department of Ophthalmology, St Thomas' Hospital, London SE1 7EH, UK.
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Apple DJ, Escobar-Gomez M, Zaugg B, Kleinmann G, Borkenstein AF. Modern cataract surgery: unfinished business and unanswered questions. Surv Ophthalmol 2012; 56:S3-53. [PMID: 22117905 DOI: 10.1016/j.survophthal.2011.10.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 10/06/2011] [Indexed: 11/18/2022]
Abstract
We summarize information, based on clinicopathologic studies over the past decade, on various cataract intraocular lens (IOL) procedures and modern "specialized" IOLs, that will help surgeons continuously improve long-term results for cataract patients. Although most operations do initially provide excellent refractive correction and visual rehabilitation, late complications occur. These sometimes are missed because they are outside of the routine period of follow-up care. We have tried to determine if the various techniques and IOLs truly deliver the long-term results that we desire. Most safety and efficacy information is derived from the manufacturer and is passed through the U.S. Food and Drug Administration (FDA). This is often based on limited, relatively short-term observations made by the manufacturer. After a lens receives FDA approval, there are few means to assess the outcome of each procedure and lens years later. We rarely hear of a 10- or 20-year follow-up study. We have found that one of the best means to assess long-term results is pathologic analyses. We discuss recently studied aspects of pathologic reactions, such as posterior capsule opacification, intracapsular fibrosis, glistenings, intralenticular opacification, and other issues with the various IOL platforms; we then present a clinicopathological overview of tissues and IOLs from our database. These include hydrophobic and hydrophilic acrylic designs, plate lenses, and a dual optic lens.
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Affiliation(s)
- David J Apple
- Laboratory for Ophthalmic Devices Research, Sullivan's Island, South Carolina, USA
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Park JH, Kim JH, Lee JE, Kim JY, Kim MJ, Tchah HW. Clinical Outcomes of Aspheric 1-Piece (Tecnis® ZCB00) and 3-Piece (Tecnis® ZA9003) Aspheric Intraocular Lens for 12 Months. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2012. [DOI: 10.3341/jkos.2012.53.10.1451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jong Hoon Park
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Hyung Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joo Eun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jea Yong Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Myoung Joon Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hung Won Tchah
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Vasavada AR, Raj SM, Shah A, Shah G, Vasavada V, Vasavada V. Comparison of posterior capsule opacification with hydrophobic acrylic and hydrophilic acrylic intraocular lenses. J Cataract Refract Surg 2011; 37:1050-9. [PMID: 21596247 DOI: 10.1016/j.jcrs.2010.12.060] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 12/11/2010] [Accepted: 12/18/2010] [Indexed: 12/21/2022]
Abstract
PURPOSE To compare posterior capsule opacification (PCO) 3 years postoperatively in contralateral eyes with a single-piece hydrophobic acrylic and 1 of 2 single-piece hydrophilic acrylic intraocular lenses (IOLs) with different configurations. SETTING Iladevi Cataract and IOL Research Institute, Ahmedabad, India. DESIGN Prospective randomized clinical trial. METHODS A hydrophobic Acrysof (hydrophobic group) or a hydrophilic C-flex (hydrophilic group C) or Akreos Adapt IOL (hydrophilic group A) was randomized for implantation in the fellow eye or vice versa of each patient. The Evaluation of Posterior Capsule Opacification (EPCO) area, EPCO score, and neodymium:YAG (Nd:YAG) capsulotomy rates were compared using digital photographs. RESULTS The study enrolled 68 patients. Although there was no significant difference at 1 month, the median EPCO score was statistically significantly lower in the hydrophobic group than in hydrophilic group C (P = .00) and hydrophilic group A (P = .000) at 3 years. There were no significant differences in the median EPCO area at 1 month; however, the area was statistically significantly less in the hydrophobic group than in hydrophilic group C and hydrophilic group A at 3 years (both P = .000). Four (12.9%) of 31 eyes in hydrophilic group C and 5 (16%) of 31 eyes in hydrophilic group A required an Nd:YAG capsulotomy; no eye in the hydrophobic group required a capsulotomy (P = .04 and P = .02, respectively). CONCLUSION Posterior capsule opacification was significantly less with the Acrysof hydrophobic acrylic IOL at 3 years. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Abhay R Vasavada
- Iladevi Cataract & IOL Research Centre, Raghudeep Eye Clinic, Memnagar, Ahmedabad, India
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Palanker DV, Blumenkranz MS, Andersen D, Wiltberger M, Marcellino G, Gooding P, Angeley D, Schuele G, Woodley B, Simoneau M, Friedman NJ, Seibel B, Batlle J, Feliz R, Talamo J, Culbertson W. Femtosecond laser-assisted cataract surgery with integrated optical coherence tomography. Sci Transl Med 2011; 2:58ra85. [PMID: 21084720 DOI: 10.1126/scitranslmed.3001305] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
About one-third of people in the developed world will undergo cataract surgery in their lifetime. Although marked improvements in surgical technique have occurred since the development of the current approach to lens replacement in the late 1960s and early 1970s, some critical steps of the procedure can still only be executed with limited precision. Current practice requires manual formation of an opening in the anterior lens capsule, fragmentation and evacuation of the lens tissue with an ultrasound probe, and implantation of a plastic intraocular lens into the remaining capsular bag. The size, shape, and position of the anterior capsular opening (one of the most critical steps in the procedure) are controlled by freehand pulling and tearing of the capsular tissue. Here, we report a technique that improves the precision and reproducibility of cataract surgery by performing anterior capsulotomy, lens segmentation, and corneal incisions with a femtosecond laser. The placement of the cuts was determined by imaging the anterior segment of the eye with integrated optical coherence tomography. Femtosecond laser produced continuous anterior capsular incisions, which were twice as strong and more than five times as precise in size and shape than manual capsulorhexis. Lens segmentation and softening simplified its emulsification and removal, decreasing the perceived cataract hardness by two grades. Three-dimensional cutting of the cornea guided by diagnostic imaging creates multiplanar self-sealing incisions and allows exact placement of the limbal relaxing incisions, potentially increasing the safety and performance of cataract surgery.
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Affiliation(s)
- Daniel V Palanker
- Department of Ophthalmology, Stanford University, Stanford, CA 94305, USA.
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