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Wong YR, Williams GP, George BL, Yam GHF, Ang MHN, Mehta JS, Tay SC. Biomechanical evaluation of porcine lens capsule with and without nucleus after capsulotomy - Finite element analysis. Comput Methods Biomech Biomed Engin 2024:1-8. [PMID: 38884185 DOI: 10.1080/10255842.2024.2364812] [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: 02/09/2024] [Accepted: 05/26/2024] [Indexed: 06/18/2024]
Abstract
Previous studies have shown that the nucleus could offer structural support to the lens capsule. This study investigated the biomechanical performance of porcine lens with and without nucleus for 4 mm, 4.5 mm, 5 mm, 5.5 mm and 6 mm capsulotomy and its potential impact on the stretch ratio of capsular bag when the anterior capsulotomy edge was stretched. Our simulation results showed higher strain for the capsular bag with nucleus, which is crucial for the porcine lens to tolerate more stretch without failure. This simulation could support future study on the optimization of capsulotomy based on patient specific condition, that is, the geometry of lens.
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Affiliation(s)
- Yoke-Rung Wong
- Biomechanics Laboratory, Singapore General Hospital, Singapore, Singapore
| | - Geraint P Williams
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
- Corneal and External Eye Disease Service, Singapore National Eye Centre, Singapore, Singapore
| | - Benjamin L George
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Gary Hin-Fai Yam
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marcus Han-Nian Ang
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
- Corneal and External Eye Disease Service, Singapore National Eye Centre, Singapore, Singapore
| | - Jodhbir S Mehta
- Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
- Corneal and External Eye Disease Service, Singapore National Eye Centre, Singapore, Singapore
| | - Shian-Chao Tay
- Biomechanics Laboratory, Singapore General Hospital, Singapore, Singapore
- Department of Hand Surgery, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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2
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Boden KT, Julich-Haertel H, Rickmann A, Szurman P, Januschowski K, Seitz B, Schlosser R, Wakili P, Müller LJ. Efficacy of a new fragmentation pattern in femtosecond laser-assisted cataract surgery with the Ziemer FEMTO LDV Z8. Int Ophthalmol 2023:10.1007/s10792-022-02619-5. [PMID: 36781625 DOI: 10.1007/s10792-022-02619-5] [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: 03/27/2022] [Accepted: 12/20/2022] [Indexed: 02/15/2023]
Abstract
PURPOSE To determine the efficacy of different fragmentation patterns in femtosecond laser-assisted cataract surgery (FLACS) using Ziemer FEMTO LDV Z8. METHODS We compared three different types of surgery: conventional cataract surgery (CCS), FLACS with conventional radial slices (named No-Spiderweb), and FLACS with a novel fragmentation pattern (radial slices combined with one or two rings) called "Spiderweb." Visual acuity (VA), nuclear opacity (NO) according to the Lens Opacities Classification System (LOCS lll), effective phacoemulsification time (EPT) and vacuum time were obtained for 845 eyes. RESULTS Using FLACS (Spiderweb + No-Spiderweb), EPT was significantly reduced by 26% compared to CCS (FLACS: 2.46 ± 2.60 s; CCS: 3.34 ± 2.89 s; ΔM = - 0.88 s, p < .001). Furthermore, EPT as a function of progression of lens opacity was found to be not only lower in Spiderweb compared to CCS, but also in comparison with No-Spiderweb. At NO3, a significant reduction of 65% in EPT was observed by using Spiderweb compared to CCS (Spiderweb: 0.68 ± 1.23 s; CCS: 1.96 ± 1.53 s; ΔM = - 1.28 s, p <.001). Interestingly, EPT at NO3 was also significantly reduced by 57% in Spiderweb compared to No-Spiderweb (Spiderweb: 0.68 ± 1.23 s; No-Spiderweb: 1.57 ± 1 .59 s; ΔM = - 0.90 s, p <.001). The use of Spiderweb only marginally extends the vacuum time compared to No-Spiderweb by 11 s (Spiderweb: 209.13 ± 35.83 s; No-Spiderweb: 198.35 ± 36.84 s; p = .003) and the postoperative improved VA showed no significant difference among the different types of surgery (all ps ≥ .05). CONCLUSION FLACS significantly reduces EPT compared to CCS. Furthermore, the novel Spiderweb pattern significantly reduces EPT in patients with a cataract of NO3 compared to CCS, but also to FLACS with the existing radial pattern (No-Spiderweb).
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Affiliation(s)
- Karl Thomas Boden
- Eye Clinic Sulzbach, Knappschaft Hospital Saar GmbH, An der Klinik 10, 66280, Sulzbach, Germany. .,Klaus Heimann Eye Research Institute (KHERI), An der Klinik 10, 66280, Sulzbach, Germany.
| | - Henrike Julich-Haertel
- Klaus Heimann Eye Research Institute (KHERI), An der Klinik 10, 66280, Sulzbach, Germany
| | - Annekatrin Rickmann
- Eye Clinic Sulzbach, Knappschaft Hospital Saar GmbH, An der Klinik 10, 66280, Sulzbach, Germany.,Centre for Ophthalmology, University Eye Hospital Tuebingen, Schleichstr. 12, 72076, Tübingen, Germany.,Klaus Heimann Eye Research Institute (KHERI), An der Klinik 10, 66280, Sulzbach, Germany
| | - Peter Szurman
- Eye Clinic Sulzbach, Knappschaft Hospital Saar GmbH, An der Klinik 10, 66280, Sulzbach, Germany.,Centre for Ophthalmology, University Eye Hospital Tuebingen, Schleichstr. 12, 72076, Tübingen, Germany.,Klaus Heimann Eye Research Institute (KHERI), An der Klinik 10, 66280, Sulzbach, Germany
| | - Kai Januschowski
- Eye Clinic Sulzbach, Knappschaft Hospital Saar GmbH, An der Klinik 10, 66280, Sulzbach, Germany.,Centre for Ophthalmology, University Eye Hospital Tuebingen, Schleichstr. 12, 72076, Tübingen, Germany.,Klaus Heimann Eye Research Institute (KHERI), An der Klinik 10, 66280, Sulzbach, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, Kirrberger Str. 100, 66424, Homburg, Saar, Germany
| | - Rosemarie Schlosser
- Eye Clinic Sulzbach, Knappschaft Hospital Saar GmbH, An der Klinik 10, 66280, Sulzbach, Germany
| | - Philip Wakili
- Eye Clinic Sulzbach, Knappschaft Hospital Saar GmbH, An der Klinik 10, 66280, Sulzbach, Germany
| | - Lisa Julia Müller
- Eye Clinic Sulzbach, Knappschaft Hospital Saar GmbH, An der Klinik 10, 66280, Sulzbach, Germany
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Yuan M, Zhang Q, Chang L. Applied research on confocal microscopy through focusing detection of tarsal glands shape following phacoemulsification for cataract. Am J Transl Res 2021; 13:10744-10750. [PMID: 34650750 PMCID: PMC8507046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/12/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the value of confocal microscopy in determining the morphology of the tarsal gland after cataract phacoemulsification. METHODS A total of 74 patients (74 eyes) who underwent phacoemulsification for a monocular cataract and intraocular lens implantation (all were single eye surgeries) in our hospital from May 2018 to October 2018 were recruited as the study cohort, with 43 male patients and 31 female patients, and a mean age of (64.8±12.5) years old. All the patients were followed up for 6 months, of whom 25 cases with MGD were included in the MGD group and 49 cases without MGD were included in the control group. All the patients were examined within 30 days and underwent IVCM inspections of the acinar morphology of the tarsal glands (expansion and atrophy), the infiltration of the inflammatory cells in the tarsal gland tissue, and a classification of the fibrosis in the tarsal gland tissue. RESULTS The longest and shortest acinar diameters in the MGD patients were significantly greater than they were in the control group, but the acinar areas were smaller than they were in the control group. The meibomian glandular vesicle densities, the average opening diameters, the fibrosis, and the inflammatory cell density in the MGD group were significantly increased. CONCLUSION IVCM plays a vital role in the early diagnosis, in the severity grading, and in the evaluation of the clinical effectiveness of MGD-related diseases, by which the morphological changes of the tarsal gland after phacoemulsification can be observed in a timely manner to predict the occurrence of MGD.
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Affiliation(s)
- Mengke Yuan
- Department of Ophthalmology, Beijing Yanhua HospitalBeijing 102500, China
| | - Qin Zhang
- Department of Ophthalmology, Peking University People’s HospitalBeijing 102500, China
| | - Libin Chang
- Department of Ophthalmology, Beijing Yanhua HospitalBeijing 102500, China
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4
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Karayilan M, Clamen L, Becker ML. Polymeric Materials for Eye Surface and Intraocular Applications. Biomacromolecules 2021; 22:223-261. [PMID: 33405900 DOI: 10.1021/acs.biomac.0c01525] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Ocular applications of polymeric materials have been widely investigated for medical diagnostics, treatment, and vision improvement. The human eye is a vital organ that connects us to the outside world so when the eye is injured, infected, or impaired, it needs immediate medical treatment to maintain clear vision and quality of life. Moreover, several essential parts of the eye lose their functions upon aging, causing diminished vision. Modern polymer science and polymeric materials offer various alternatives, such as corneal and scleral implants, artificial ocular lenses, and vitreous substitutes, to replace the damaged parts of the eye. In addition to the use of polymers for medical treatment, polymeric contact lenses can provide not only vision correction, but they can also be used as wearable electronics. In this Review, we highlight the evolution of polymeric materials for specific ocular applications such as intraocular lenses and current state-of-the-art polymeric systems with unique properties for contact lens, corneal, scleral, and vitreous body applications. We organize this Review paper by following the path of light as it travels through the eye. Starting from the outside of the eye (contact lenses), we move onto the eye's surface (cornea and sclera) and conclude with intraocular applications (intraocular lens and vitreous body) of mostly synthetic polymers and several biopolymers. Initially, we briefly describe the anatomy and physiology of the eye as a reminder of the eye parts and their functions. The rest of the Review provides an overview of recent advancements in next-generation contact lenses and contact lens sensors, corneal and scleral implants, solid and injectable intraocular lenses, and artificial vitreous body. Current limitations for future improvements are also briefly discussed.
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Affiliation(s)
- Metin Karayilan
- Department of Chemistry, Duke University, Durham, North Carolina 27708, United States
| | - Liane Clamen
- Adaptilens, LLC, Boston, Massachusetts 02467, United States
| | - Matthew L Becker
- Department of Chemistry, Duke University, Durham, North Carolina 27708, United States.,Mechanical Engineering and Materials Science, Orthopaedic Surgery, and Biomedical Engineering, Duke University, Durham, North Carolina 27708, United States
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Cheng KJ, Hsieh CM, Nepali K, Liou JP. Ocular Disease Therapeutics: Design and Delivery of Drugs for Diseases of the Eye. J Med Chem 2020; 63:10533-10593. [PMID: 32482069 DOI: 10.1021/acs.jmedchem.9b01033] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The ocular drug discovery field has evidenced significant advancement in the past decade. The FDA approvals of Rhopressa, Vyzulta, and Roclatan for glaucoma, Brolucizumab for wet age-related macular degeneration (wet AMD), Luxturna for retinitis pigmentosa, Dextenza (0.4 mg dexamethasone intracanalicular insert) for ocular inflammation, ReSure sealant to seal corneal incisions, and Lifitegrast for dry eye represent some of the major developments in the field of ocular therapeutics. A literature survey also indicates that gene therapy, stem cell therapy, and target discovery through genomic research represent significant promise as potential strategies to achieve tissue repair or regeneration and to attain therapeutic benefits in ocular diseases. Overall, the emergence of new technologies coupled with first-in-class entries in ophthalmology are highly anticipated to restructure and boost the future trends in the field of ophthalmic drug discovery. This perspective focuses on various aspects of ocular drug discovery and the recent advances therein. Recent medicinal chemistry campaigns along with a brief overview of the structure-activity relationships of the diverse chemical classes and developments in ocular drug delivery (ODD) are presented.
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Affiliation(s)
- Kuei-Ju Cheng
- School of Pharmacy, College of Pharmacy, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan.,Department of Pharmacy, Taipei Municipal Wanfang Hospital, Taipei Medical University, No. 111, Section 3, Xing-Long Road, Taipei 11696, Taiwan
| | - Chien-Ming Hsieh
- School of Pharmacy, College of Pharmacy, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan
| | - Kunal Nepali
- School of Pharmacy, College of Pharmacy, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan
| | - Jing-Ping Liou
- School of Pharmacy, College of Pharmacy, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan
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