1
|
Hidalgo-Alvarez V, Falcon ND, Eldred J, Wormstone M, Saeed A. Stereolithographic Rapid Prototyping of Clear, Foldable, Non-Refractive Intraocular Lens Designs: A Proof-of-Concept Study. Curr Eye Res 2024; 49:843-852. [PMID: 38762982 DOI: 10.1080/02713683.2024.2344164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/11/2024] [Indexed: 05/21/2024]
Abstract
PURPOSE A cataract is a cloudy area in the crystalline lens. Cataracts are the leading cause of blindness and the second cause of severe vision impairment worldwide. During cataract surgery, the clouded lens is extracted and replaced with an artificial intraocular lens, which restores the optical power. The fabrication of intraocular lenses using existing molding and lathing techniques is a complex and time-consuming process that limits the development of novel materials and designs. To overcome these limitations, we have developed a stereolithography-based process for producing models of clear lens designs without refractive function, serving as a proof of concept. This process has the potential to contribute toward new lens development, allowing for unlimited design iterations and an expanded range of materials for scientists to explore. METHODS Lens-like 3D objects without refractive function were fabricated by using stereolithography. A photopolymerizable resin containing 2-phenoxyethyl acrylate, poly (ethylene glycol) dimethacrylate, and a suitable photoinitiator was developed for the production of lens-like 3D object prototypes. The morphology of the printed devices was characterized by scanning electron microscopy. The transparency and thermal properties were analyzed using spectrophotometry and differential scanning calorimetry, respectively. The biocompatibility of the devices was investigated in a cultured human lens cell line (FHL-124), using a standard lactate dehydrogenase assay, and the lenses were folded and implanted in the human capsular bag model. RESULTS One-piece lens-like 3D objects without refractive function and with loop-haptic design were successfully fabricated using Stereolithography (SLA) technique. The resulting 3D objects were transparent, as determined by UV spectroscopy. The lactate dehydrogenase test demonstrated the tolerance of lens cells to the prototyping material, and apparent foldability and shape recovery was observed during direct injection into a human capsular bag model in vitro. CONCLUSIONS This proof-of-principle study demonstrated the potential and significance of the rapid prototyping process for research and development of lens-like 3D object prototypes, such as intraocular lenses.
Collapse
Affiliation(s)
| | | | - Julie Eldred
- School of Biological Sciences, University of East Anglia, Norwich, UK
| | - Michael Wormstone
- School of Biological Sciences, University of East Anglia, Norwich, UK
| | - Aram Saeed
- School of Pharmacy, University of East Anglia, Norwich, UK
| |
Collapse
|
2
|
Baur ID, Łabuz G, Chychko L, Yildirim TM, Naujokaitis T, Auffarth GU, Khoramnia R. In vivo comparison of implantation behavior and laboratory analysis of two preloaded intraocular lens injectors. Eur J Ophthalmol 2024; 34:766-773. [PMID: 37750504 PMCID: PMC11082425 DOI: 10.1177/11206721231204382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 09/13/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE We evaluated implantation behavior and injector damage of two different IOL injector systems, the Multisert and the AutonoMe. DESIGN Prospective, randomized, comparative study with laboratory investigation. METHODS We examined used injectors from 48 bilateral cataract cases and assessed video recordings of each Implantation. All eyes were intraindividually randomized for treatment with one of the two IOL injectors. Implantation videos were reviewed for inadvertent events and the time for different implantation steps was determined. The injector nozzle tips were examined using light and scanning electron microscopy (SEM). Damage was graded using the Heidelberg Score for IOL injector damage (HeiScore). Three months postoperatively, IOLs were assessed for material changes. RESULTS Implantation was without critical events in 96 of 96 eyes. Mean implantation time was 41.90 ± 7.11 s with the Multisert and 52.22 ± 12.06 s with the AutonoMe. In the AutonoMe group, we observed 4 eyes (8.3%) with a failed docking attempt, 28 eyes (58.3%) with a haptic adherence, one case (2.1%) of straight leading haptic and 2 cases (4.2%) of intrawound IOL manipulation. There were no events observed in the Multisert group. The mean HeiScore values were 0.87 ± 0.61 and 3.68 ± 0.47 for the AutonoMe and Multisert. 3 months postoperatively, IOL material changes were absent. CONCLUSIONS Both injectors allowed safe and controlled implantation. Using Multisert, implantation behavior was more consistent. The injectors showed different damage profiles with a higher damage score for the Multisert.The study is registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien; reference number: DRKS00007837).
Collapse
Affiliation(s)
- Isabella D Baur
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Grzegorz Łabuz
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Lizaveta Chychko
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Timur M Yildirim
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Tadas Naujokaitis
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Gerd U Auffarth
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
3
|
Schickhardt SK, Łabuz G, Munro DJ, Lieberwirth I, Zhang L, Fang H, Auffarth GU. In-vitro assessment of a novel intraocular lens made of crosslinked polyisobutylene. J Mech Behav Biomed Mater 2024; 152:106368. [PMID: 38340476 DOI: 10.1016/j.jmbbm.2023.106368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE To describe and analyse the particularities of the material and the optical quality of the first intraocular lens (IOL) (Eyedeal® lens) made of crosslinked polyisobutylene (xPIB). METHODS We assessed the material quality using an accelerated ageing process (to provoke glistenings) and compared values with a control, AcrySof® lens. Using the sessile drop method, the contact angle of the new IOL was measured. Images of the lens surface were recorded by scanning electron microscopy (SEM). Optical quality was assessed by measuring the labeled power and modulation transfer function (MTF) using standard metrology equipment (OptiSpheric IOL PRO2). RESULTS The Eyedeal® lens had an average glistening density result of 7.46 ± 3.78 MV/mm2 compared to the control AcrySof® whose glistenings number was 142.42 ± 72.47 MV/mm2. The contact angle was 97.2° whereas the angle of AcrySof material is between 73.3 ± 2.4° and 84.4 ± 0.1°. Using SEM, Eyedeal® lenses were examined and all appeared to be comparable to modern IOLs made of acrylic materials. The power and MTF values were normal and conformed to ISO standards. CONCLUSIONS In the laboratory, the new Eyedeal® lens showed equivalence to current hydrophobic- or hydrophilic-acrylic lens models. It showed superiority in its glistening density result compared to the control lens.
Collapse
Affiliation(s)
- Sonja K Schickhardt
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital of Heidelberg, Heidelberg, Germany.
| | - Grzegorz Łabuz
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital of Heidelberg, Heidelberg, Germany.
| | - Donald J Munro
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital of Heidelberg, Heidelberg, Germany.
| | | | - Lu Zhang
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital of Heidelberg, Heidelberg, Germany.
| | - Hui Fang
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital of Heidelberg, Heidelberg, Germany.
| | - Gerd U Auffarth
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital of Heidelberg, Heidelberg, Germany.
| |
Collapse
|
4
|
Fernández-Vigo JI, Serrano González-Peramato MT, Nunila Gómez-de-Liaño C, Sánchez-Guillén I, Fernández-Vigo JÁ, Macarro-Merino A. Glistening on intraocular lenses: A review. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:493-506. [PMID: 37369324 DOI: 10.1016/j.oftale.2023.06.016] [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: 05/14/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
The glistening in intraocular lenses (IOLs) is a phenomenon in which tiny water-filled microvacuoles (MVs) form within the IOL material, causing light to scatter and create a sparkling or shimmering effect. The presence of glistening is common in many types of IOL materials and models and has been extensively studied in recent years to determine its incidence, risk factors, evolution, and possible clinical relevance. Classically, it has been studied in vitro in the laboratory or by means of photography obtained with a slit lamp, but these were techniques that required either specific technology or an expert explorer, complex image processing, and required a lot of time. In recent years, proposals based on the Scheimpflug camera and optical coherence tomography have emerged to try to simplify the analysis of glistening in IOLs. It has been described that the manufacturing process, the hydrophobic acrylic material, or the time since surgery are risk factors for the appearance of glistening. In addition, many issues related to this phenomenon are still unknown, such as not knowing from what number of points or their size they may have relevance to visual function since different optical phenomena related to glistening have been described on the IOLs.
Collapse
Affiliation(s)
- J I Fernández-Vigo
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Madrid, Spain.
| | | | - C Nunila Gómez-de-Liaño
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - I Sánchez-Guillén
- Servicio de Oftalmología, Hospital Perpetuo Socorro, Badajoz, Spain; Centro Internacional de Oftalmología Avanzada, Badajoz, Spain
| | - J Á Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Badajoz, Spain; Departamento de Oftalmología, Facultad de Medicina, Universidad de Extremadura, Badajoz, Spain
| | - A Macarro-Merino
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain; Centro Internacional de Oftalmología Avanzada, Badajoz, Spain
| |
Collapse
|
5
|
Stanojcic N, Hull CC, Mangieri E, Little N, O'Brart D. A new software for automated counting of glistenings in intraocular lenses in vivo. Int J Ophthalmol 2023; 16:1237-1242. [PMID: 37602355 PMCID: PMC10398534 DOI: 10.18240/ijo.2023.08.08] [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: 06/03/2022] [Accepted: 05/24/2023] [Indexed: 08/22/2023] Open
Abstract
AIM To assess the performance of a bespoke software for automated counting of intraocular lens (IOL) glistenings in slit-lamp images. METHODS IOL glistenings from slit-lamp-derived digital images were counted manually and automatically by the bespoke software. The images of one randomly selected eye from each of 34 participants were used as a training set to determine the threshold setting that gave the best agreement between manual and automatic grading. A second set of 63 images, selected using randomised stratified sampling from 290 images, were used for software validation. The images were obtained using a previously described protocol. Software-derived automated glistenings counts were compared to manual counts produced by three ophthalmologists. RESULTS A threshold value of 140 was determined that minimised the total deviation in the number of glistenings for the 34 images in the training set. Using this threshold value, only slight agreement was found between automated software counts and manual expert counts for the validating set of 63 images (κ=0.104, 95%CI, 0.040-0.168). Ten images (15.9%) had glistenings counts that agreed between the software and manual counting. There were 49 images (77.8%) where the software overestimated the number of glistenings. CONCLUSION The low levels of agreement show between an initial release of software used to automatically count glistenings in in vivo slit-lamp images and manual counting indicates that this is a non-trivial application. Iterative improvement involving a dialogue between software developers and experienced ophthalmologists is required to optimise agreement. The results suggest that validation of software is necessary for studies involving semi-automatic evaluation of glistenings.
Collapse
Affiliation(s)
- Nick Stanojcic
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK
- Centre for Applied Vision Research, School of Health Sciences, University of London, London EC1V 0HB, UK
- King's College, London WC2R 2LS, UK
| | - Christopher C. Hull
- Centre for Applied Vision Research, School of Health Sciences, University of London, London EC1V 0HB, UK
| | | | | | - David O'Brart
- Department of Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London SE1 7EH, UK
- King's College, London WC2R 2LS, UK
| |
Collapse
|
6
|
Nuijts RM, Bhatt U, Nanavaty MA, Roberts TV, Peterson R, Teus MA. Three-year multinational clinical study on an aspheric hydrophobic acrylic intraocular lens. J Cataract Refract Surg 2023; 49:672-678. [PMID: 36848238 PMCID: PMC10284131 DOI: 10.1097/j.jcrs.0000000000001173] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/23/2023] [Accepted: 02/16/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE To present the results of a study investigating the 3-year effectiveness and safety of the Clareon single-piece intraocular lens (IOL). SETTING 19 multinational sites. DESIGN Prospective multicenter single-arm study. METHODS Patients were bilaterally implanted with Clareon IOLs. Assessments included uncorrected distance visual acuity, corrected distance visual acuity (CDVA), manifest refraction, tilt, decentration, applanation tonometry, and fundus examination, including glistenings and posterior capsule opacification (PCO) evaluation. The primary outcomes for effectiveness and safety were evaluated at 1 year and compared with ISO historical safety and performance endpoint (SPE) rates. Patients were followed for up to 3 years after implantation. RESULTS 424 eyes of 215 patients were implanted (n = 215 first eye, n = 209 second eye), and 183 patients completed the trial at 3 years (with 364 binocular and 1 monocular patient). At 1 year, the cumulative and persistent adverse event rates were below SPE targets, and 99.5% of eyes achieved a monocular CDVA of ≤0.3 logMAR (vs the SPE target of 92.5%). At 3 years, the mean monocular CDVA was -0.032, with 93.4% (341/365) of eyes achieving a CDVA of 0.1 logMAR or better, 100% of eyes presented with grade 0 glistenings ≤25 MV/mm 2 , and 92.9% of eyes (394/424) had either no PCO or clinically nonsignificant PCO. CONCLUSIONS This study supports the long-term safety and effectiveness of the Clareon IOL. The visual outcomes were excellent and stable over the 3-year study period, PCO rates were very low, and 100% of IOLs had grade 0 glistenings.
Collapse
Affiliation(s)
- Rudy M.M.A. Nuijts
- From the University Eye Clinic, Maastricht University Medical Center, Maastricht, the Netherlands (Nuijts); Vision Eye Institute, Melbourne, Victoria, Australia (Bhatt); Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom (Nanavaty); Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia (Roberts); Vision Eye Institute, Sydney, New South Wales, Australia (Roberts); Alcon Laboratories LLC, Fort Worth, Texas (Peterson); Hospital Universitario Principe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain (Teus)
| | - Uday Bhatt
- From the University Eye Clinic, Maastricht University Medical Center, Maastricht, the Netherlands (Nuijts); Vision Eye Institute, Melbourne, Victoria, Australia (Bhatt); Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom (Nanavaty); Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia (Roberts); Vision Eye Institute, Sydney, New South Wales, Australia (Roberts); Alcon Laboratories LLC, Fort Worth, Texas (Peterson); Hospital Universitario Principe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain (Teus)
| | - Mayank A. Nanavaty
- From the University Eye Clinic, Maastricht University Medical Center, Maastricht, the Netherlands (Nuijts); Vision Eye Institute, Melbourne, Victoria, Australia (Bhatt); Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom (Nanavaty); Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia (Roberts); Vision Eye Institute, Sydney, New South Wales, Australia (Roberts); Alcon Laboratories LLC, Fort Worth, Texas (Peterson); Hospital Universitario Principe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain (Teus)
| | - Timothy V. Roberts
- From the University Eye Clinic, Maastricht University Medical Center, Maastricht, the Netherlands (Nuijts); Vision Eye Institute, Melbourne, Victoria, Australia (Bhatt); Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom (Nanavaty); Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia (Roberts); Vision Eye Institute, Sydney, New South Wales, Australia (Roberts); Alcon Laboratories LLC, Fort Worth, Texas (Peterson); Hospital Universitario Principe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain (Teus)
| | - Rachael Peterson
- From the University Eye Clinic, Maastricht University Medical Center, Maastricht, the Netherlands (Nuijts); Vision Eye Institute, Melbourne, Victoria, Australia (Bhatt); Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom (Nanavaty); Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia (Roberts); Vision Eye Institute, Sydney, New South Wales, Australia (Roberts); Alcon Laboratories LLC, Fort Worth, Texas (Peterson); Hospital Universitario Principe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain (Teus)
| | - Miguel A. Teus
- From the University Eye Clinic, Maastricht University Medical Center, Maastricht, the Netherlands (Nuijts); Vision Eye Institute, Melbourne, Victoria, Australia (Bhatt); Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom (Nanavaty); Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia (Roberts); Vision Eye Institute, Sydney, New South Wales, Australia (Roberts); Alcon Laboratories LLC, Fort Worth, Texas (Peterson); Hospital Universitario Principe de Asturias, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain (Teus)
| |
Collapse
|
7
|
Fernández-Vigo JI, Burgos-Blasco B, De-Pablo-Gómez-de-Liaño L, Sánchez-Guillén I, Albitre-Barca V, Fernández-Aragón S, Fernández-Vigo JÁ, Macarro-Merino A. Reply to Stanojcic et al. Comment on "Fernández-Vigo et al. Objective Classification of Glistening in Implanted Intraocular Lenses Using Optical Coherence Tomography: Proposal for a New Classification and Grading System. J. Clin. Med. 2023, 12, 2351". J Clin Med 2023; 12:jcm12113686. [PMID: 37297882 DOI: 10.3390/jcm12113686] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
We appreciate the comments made by Stanojcic et al. [...].
Collapse
Affiliation(s)
- José Ignacio Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), 28040 Madrid, Spain
| | - Bárbara Burgos-Blasco
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), 28040 Madrid, Spain
| | - Lucía De-Pablo-Gómez-de-Liaño
- Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain
- Department of Ophthalmology, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Inés Sánchez-Guillén
- Department of Ophthalmology, Hospital Perpetuo Socorro, 06010 Badajoz, Spain
- Centro Internacional de Oftalmología Avanzada, 06011 Badajoz, Spain
| | | | | | - José Ángel Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain
- Centro Internacional de Oftalmología Avanzada, 06011 Badajoz, Spain
- Department of Ophthalmology, Universidad de Extremadura, 06006 Badajoz, Spain
| | - Ana Macarro-Merino
- Centro Internacional de Oftalmología Avanzada, 28010 Madrid, Spain
- Centro Internacional de Oftalmología Avanzada, 06011 Badajoz, Spain
| |
Collapse
|
8
|
Objective Classification of Glistening in Implanted Intraocular Lenses Using Optical Coherence Tomography: Proposal for a New Classification and Grading System. J Clin Med 2023; 12:jcm12062351. [PMID: 36983351 PMCID: PMC10057385 DOI: 10.3390/jcm12062351] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/10/2023] [Accepted: 03/15/2023] [Indexed: 03/22/2023] Open
Abstract
Purpose: To propose a classification of the glistening in intraocular lenses (IOL) using swept-source optical coherence tomography (SS-OCT) by means of a simple, objective and reproducible method that allows the quantification of the presence and severity of glistening. Methods: A cross-sectional study on a sample of 150 eyes of 150 patients who underwent cataract surgery in at least 600 days before the exam and attended a routine examination. Each subject was examined by SS-OCT after pupil dilation, identifying the presence of glistening or hyperreflective foci (HRF) in the central area of the IOL. The degree of glistening was classified into four categories: 0: ≤5 HRF; 1: 6 to 15 HRF; 2: 16 to 30 HRF; and 3: >30 HRF. The intra and interobserver reproducibility (intraclass correlation coefficient, ICC) in the quantification and classification of the glistening were calculated. The correlation between the horizontal and vertical scan of the IOL was also assessed. Results: Glistening was present in the IOL in 42.7% of the patients. The mean number of HRF or glistening microvacuoles was 10.4 ± 26.2 (range 0 to 239). In total, 63.3% of the IOLs had a grade 0, 20% grade a 1, 6.7% grade a 2 and 10% a grade 3. The intraobserver and interobserver reproducibility were very high, both for the absolute quantification of the glistening (ICC ≥ 0.994) and for the severity scale (ICC ≥ 0.967). There was an excellent correlation in the quantification of the IOL glistening between the horizontal and vertical scans (R ≥ 0.834; p < 0.001). Conclusions: The use of SS-OCT makes it possible to identify, quantify and classify IOL glistening in a simple, objective and reproducible way. This technique could provide relevant information for the study of the glistening on IOLs.
Collapse
|
9
|
Dick HB, Ang RE, Corbett D, Hoffmann P, Tetz M, Villarrubia A, Palomino C, Castillo-Gomez A, Tsai L, Thomas EK, Janakiraman P. Comparison of 3-month visual outcomes of a new multifocal intraocular lens vs a trifocal intraocular lens. J Cataract Refract Surg 2022; 48:1270-1276. [PMID: 35545816 PMCID: PMC9622366 DOI: 10.1097/j.jcrs.0000000000000971] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 05/09/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE To compare the clinical performance of the TECNIS Synergy multifocal (model ZFR00V) intraocular lens (IOL) with that of the AcrySof PanOptix Trifocal (model TFNT00) IOL in patients undergoing bilateral cataract surgery. SETTING Multicenter clinical setting. DESIGN Prospective randomized comparative study. METHODS Patients aged 22 years or older were randomly assigned (2:1) to bilateral implantation with ZFR00V or TFNT00 IOLs. End points included the mean binocular distance-corrected near visual acuity (DCNVA) at 40 cm, photopic and mesopic DCNVAs at 33 cm, photopic low-contrast corrected distance visual acuity (CDVA) and mesopic CDVA, nondirected patient responses to an ocular/visual symptoms questionnaire, and safety. RESULTS Of the 150 patients implanted with IOLs, 95 of the 97 patients with ZFR00V IOLs and 52 of the 53 patients with TFNT00 IOLs completed the 3-month follow-up. Most patients in the ZFR00V and TFNT00 groups achieved 20/25 or better binocular CDVA (100% vs 96.2%) and DCNVA measured at 40 cm (88.4% vs 75.0%) and 33 cm (78.9% vs 51.9%). The mean between-group difference in binocular DCNVA at 40 cm favored ZFR00V IOLs (0.5 lines Snellen; 95% CI, 0.012 to 0.089; P ≤ .05). Similarly, the mean binocular photopic and mesopic DCNVAs at 33 cm (0.8 lines Snellen each; both P ≤ .05 vs TFNT00) and photopic high-contrast and low-contrast CDVA (0.5 lines Snellen each; both P ≤ .05 vs TFNT00) favored ZFR00V IOLs. Patient-reported ocular/visual symptoms and safety were generally similar between the 2 IOLs. CONCLUSIONS The ZFR00V IOL showed an extensive range of vision, particularly through near distances, and better mesopic performance than the TFNT00 IOL in patients undergoing cataract surgery.
Collapse
|
10
|
Hong Y, Zou H, Hu Y, Fei F, Liang L, Liu D, Han Y, Lin Q. Design of foldable, responsively drug-eluting polyacrylic intraocular lens bulk materials for prevention of postoperative complications. J Mater Chem B 2022; 10:8398-8406. [PMID: 36250493 DOI: 10.1039/d2tb01974d] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Posterior capsular opacification (PCO), resulting from undesired intracapsular cell proliferation, is the most common complication of intraocular lens (IOL) implantation after cataract surgery. In recent years, IOLs have been developed into a drug delivery platform. Compared with traditional eye drops, drug-loaded IOLs have the characteristics of independent patient compliance and no other operation except surgical implantation. In this work, a series of poly(glycidyl methacrylate-co-2-(2-ethoxyethoxy)ethyl acrylate) (PGE) acrylic intraocular lens materials were synthesized as drug delivery platforms. The PGE synthesized with 10% crosslinking agent has excellent optical, foldable, and thermomechanical properties. An aldehyde group was subsequently introduced into the PGE chains, and an antiproliferative drug (doxorubicin) was immobilized onto the PGE chains via an H+-sensitive imine bond. The IOL exhibits H+-dependent Dox release behavior in a simulated pathological environment. The in vitro and in vivo systematical evaluations indicate that such a responsively drug-eluting PGE IOL can effectively prevent PCO.
Collapse
Affiliation(s)
- Yueze Hong
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, P. R. China.
| | - Haoyu Zou
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, P. R. China.
| | - Yulin Hu
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, P. R. China.
| | - Fan Fei
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, P. R. China.
| | - Lin Liang
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, P. R. China.
| | - Dong Liu
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, P. R. China.
| | - Yuemei Han
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, P. R. China.
| | - Quankui Lin
- Department of Biomaterials, School of Ophthalmology & Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou 325027, P. R. China.
| |
Collapse
|
11
|
Bhattacharjee H, Bhattacharjee K, Das D, Javeri H, Buragohain S. Raman Spectroscopy of six explanted acrylic hydrophobic foldable intraocular lenses with glistening. Indian J Ophthalmol 2022; 70:2872-2876. [PMID: 35918934 DOI: 10.4103/ijo.ijo_3083_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose To study and interpret Raman spectra of six explanted acrylic hydrophobic foldable intraocular lenses (HFIOLs) with grade six microvacuoles and to understand the possible mechanism for microvacuole formation. Methods Clinical data, slit-lamp photographs, and optical microphotographs of the explanted analytes were obtained. RS of the analytes were registered using a confocal Raman microscope (Lab RAM HR Evolution, Horiba Jobin Yvon) and Horiba Lab Space 6 Spectroscopy Suite software. Data were interpreted by identifying the functional group and fingerprint region of the spectra about the available literature. Results IOLs were explanted for visual impairment after an average interval of 11.2 years following implantation. Each of the HFIOLs exhibited distinctive and identical Raman bands at the frequency range of 200-1,800, 2,600-3,000, and 3,200-3,700 cm-1 which were identified with those reported in the literature. The unique bands and peaks of the spectra were specific to the functional groups, its ring and other stretching variations, hydroxyl group, and water molecule. A spike at 1,640 cm-1 revealed the presence of monomer and indicated material bioincompatibility of the samples. Conclusion Raman spectroscopy (RS) was found specific and an effective tool to detect the material change in the HFIOL and constituents of polymer biomaterial about microvacuole formation and also suggested modification and development of a more biocompatible and non-biodegradable polymer blend where RS could be a monitoring tool.
Collapse
Affiliation(s)
| | | | - Dipankar Das
- Department of Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Henal Javeri
- Department of Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | | |
Collapse
|
12
|
Khoramnia R, Yildirim TM, Weindler J, Naujokaitis T, Dzhambazova M, Auffarth GU. Preloaded injectors used in a clinical study: videographic assessment and laboratory analysis of injector nozzle damage. J Cataract Refract Surg 2021; 47:1338-1344. [PMID: 34469394 DOI: 10.1097/j.jcrs.0000000000000587] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate quality and duration of implantation of 2 preloaded intraocular lens (IOL) injectors and assess postimplantation damage. SETTING The David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany. DESIGN Prospective, randomized, comparative study with laboratory investigation. METHODS Implantation videos and postuse injectors from 60 paired eyes of 30 bilateral cataract patients were included. Patient eyes were randomly assigned for implantation with 2 different preloaded injectors: the AutonoMe with a Clareon IOL (Alcon Laboratories, Inc.) and the iSert with a Vivinex IOL (Hoya Corp.). Videos were reviewed for events during the implantation procedure, and the duration of each step of implantation. Injector nozzles were examined under light and scanning electron microscopy. Damage was graded and correlated with the IOL power. Three months postoperatively IOLs were assessed for material changes. RESULTS IOL delivery was without any critical events in 60 of the 60 eyes. The implantation took 56 seconds with the AutonoMe and 44 seconds with the iSert (P < .05). Most AutonoMe injectors (29; 97%) showed no damage or slight deformation. In most of the iSert injectors (25; 80%), short or extended cracks were present, and damage lengths correlated with the IOL power. All IOLs were free of material changes, including glistenings, 3 months postoperatively. CONCLUSIONS Both preloaded IOL injectors allowed a safe and convenient IOL delivery. Implantation of the Clareon IOL took, on average, slightly longer than that of the Vivinex IOL, mostly due to a slower IOL unfolding. The AutonoMe showed less nozzle tip damage than that of the iSert.
Collapse
Affiliation(s)
- Ramin Khoramnia
- From the The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | | | | | | | | | | |
Collapse
|
13
|
Son HS, Łabuz G, Khoramnia R, Yildirim TM, Choi CY, Knorz MC, Auffarth GU. Visualization of Forward Light Scatter in Opacified Intraocular Lenses and Straylight Assessment. Diagnostics (Basel) 2021; 11:diagnostics11081512. [PMID: 34441445 PMCID: PMC8393541 DOI: 10.3390/diagnostics11081512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/10/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Qualitative visualization of forward light scatter and quantitative straylight measurement of intraocular lenses (IOLs). Methods: We analyzed two calcified IOL-explants, the Euromaxx ALI313Y (Argonoptics GmbH) and the LS-312 MF30 (Oculentis BV), one IOL with artificially induced glistenings (PC-60AD, Hoya), and one control (CT Asphina 409MP, Carl Zeiss Meditec AG) free of any opacification. Analysis included light microscopy, qualitative light scatter visualization using ray propagation imaging technique, and quantitative straylight measurement using C-Quant (Oculus). Results: More light scattering effect—visible as increased light intensity outside the IOL’s main focus—was evident in all opacified IOLs than the control. The highest straylight levels were observed in the Euromaxx (289.71 deg2/sr), which showed extensive granular deposits throughout its optic, followed by the MF30 (78.58 deg2/sr), which only showed opacification in its center. The glistenings-IOL demonstrated numerous microvacuoles within the optic and had straylight levels of 22.6 deg2/sr, while the control showed the lowest straylight levels (1.7 deg2/sr). Conclusions: Ray propagation imaging technique allowed qualitative assessment of off-axis veils of light that result from increased forward light scattering. Straylight was increased in all opacified lenses compared to the clear control lens. The IOL opacifications are significant sources of glare.
Collapse
Affiliation(s)
- Hyeck-Soo Son
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, 69117 Heidelberg, Germany; (H.-S.S.); (G.Ł.); (R.K.); (T.M.Y.); (C.Y.C.)
| | - Grzegorz Łabuz
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, 69117 Heidelberg, Germany; (H.-S.S.); (G.Ł.); (R.K.); (T.M.Y.); (C.Y.C.)
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, 69117 Heidelberg, Germany; (H.-S.S.); (G.Ł.); (R.K.); (T.M.Y.); (C.Y.C.)
| | - Timur M. Yildirim
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, 69117 Heidelberg, Germany; (H.-S.S.); (G.Ł.); (R.K.); (T.M.Y.); (C.Y.C.)
| | - Chul Young Choi
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, 69117 Heidelberg, Germany; (H.-S.S.); (G.Ł.); (R.K.); (T.M.Y.); (C.Y.C.)
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
| | - Michael C. Knorz
- FreeVis LASIK Center, Medical Faculty Mannheim of the University of Heidelberg, 68167 Mannheim, Germany;
| | - Gerd U. Auffarth
- The David J. Apple International Laboratory for Ocular Pathology and International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, University of Heidelberg, 69117 Heidelberg, Germany; (H.-S.S.); (G.Ł.); (R.K.); (T.M.Y.); (C.Y.C.)
- Correspondence:
| |
Collapse
|
14
|
Yildirim TM, Schickhardt SK, Wang Q, Friedmann E, Khoramnia R, Auffarth GU. Quantitative evaluation of microvacuole formation in five intraocular lens models made of different hydrophobic materials. PLoS One 2021; 16:e0250860. [PMID: 33930084 PMCID: PMC8087009 DOI: 10.1371/journal.pone.0250860] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 04/15/2021] [Indexed: 11/29/2022] Open
Abstract
In this laboratory study, we assessed the resistance to microvacuole (glistening) formation in hydrophobic intraocular lenses (IOLs). Glistenings were induced in five lenses each of five different hydrophobic acrylic IOL models, using an established in vitro laboratory model: 800C (Rayner, Worthing, UK), AcrySof SN60WF (Alcon, Fort Worth, USA), Tecnis ZCB00 (Johnson & Johnson Vision, Santa Ana, USA), Vivinex XY1 (Hoya, Tokyo, Japan) and CT Lucia 611P (Zeiss, Oberkochen, Germany). We evaluated the number of microvacuoles per square millimeter (MV/mm2) in the central part of each IOL. Results were analyzed statistically, and mean glistening numbers were ranked, with the highest in the SN60WF which had 66.0 (±45.5) MVs/mm, followed by the 611P with 30.7 (±8.4) MVs/mm2. The 800C and XY1 showed comparable values of 2.0 (±3.6) and 2.7 (±2.4) MVs/mm2, respectively. ZCB00 had the lowest number with 0.9 (±0.6) MVs/mm2. This study shows that the resistance to glistening formation differs depending on the hydrophobic acrylic copolymer composition of the IOL material. Some IOLs from current clinical use are still prone to develop glistenings whereas others, including the ZCB00, 800C and XY1 show high resistance to microvacuole formation.
Collapse
Affiliation(s)
- Timur M. Yildirim
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Sonja K. Schickhardt
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Qiang Wang
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
- Department of Ophthalmology, The Third Affiliated Hospital of Wenzhou Medical University, Rui’an, Zhejiang, China
| | - Elfriede Friedmann
- Faculty of Mathematics and Natural Sciences, University of Kassel, Kassel, Germany
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Gerd U. Auffarth
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
15
|
Abstract
The spectrum of complications in the use of intraocular lenses (IOL) is different today from at the time of their introduction. Opacities in the IOL material are increasingly described in the literature as a reason for IOL explantation. This paper provides an overview of the different forms of IOL material opacities. Currently relevant forms of IOL material opacities and their effects on optical quality are summarized. The main reason for opacification in hydrophilic IOLs is calcification, whereas in hydrophobic IOLs it is mainly the formation of so-called glistenings that is reported. Most material opacities affect various optical parameters and lead to increased intraocular straylight. In case of a disturbing material opacification, the only therapeutic option is to replace the opacified IOL.
Collapse
|
16
|
Khoramnia R. Eintrübung von Intraokularlinsen. AUGENHEILKUNDE UP2DATE 2021. [DOI: 10.1055/a-1250-3703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ZusammenfassungDas Spektrum an Komplikationen und die Explantationsgründe bei der Verwendung von
Intraokularlinsen (IOL) haben sich durch die Weiterentwicklung der
Kataraktchirurgie verändert. Eintrübungen des Materials beeinflussen dabei
unterschiedlich stark die optische Qualität. Im Fall einer störenden Eintrübung
des Materials ist auch heute noch – trotz aller Fortschritte auf dem Gebiet der
IOL-Materialien – ein Austausch der IOL die einzige Behandlungsoption.
Collapse
|
17
|
Wang Q, Yildirim TM, Schickhardt SK, Łabuz G, Khoramnia R, Merz PR, Son HS, Munro DJ, Friedmann E, Auffarth GU. Quantification of the In Vitro Predisposition to Glistening Formation in One Manufacturer's Acrylic Intraocular Lenses Made in Different Decades. Ophthalmol Ther 2021; 10:165-174. [PMID: 33544374 PMCID: PMC7886932 DOI: 10.1007/s40123-020-00329-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/24/2020] [Indexed: 11/27/2022] Open
Abstract
Introduction Foldable hydrophobic acrylic intraocular lenses (IOLs) are prone to develop a long-term postoperative material change called glistenings. The aim of this study was to investigate the changes in the predisposition for glistening formation in one type of hydrophobic acrylic IOL material from its introduction to the present day. Methods In a laboratory setup, an in vitro model was used to induce glistenings in hydrophobic acrylic IOLs manufactured by one company (Alcon, Fort Worth, TX, USA) in different years: 23 1990s-manufacture hydrophobic acrylic three-piece IOLs (MA30BA/MA60AC) that were explanted in 1996 and 1997, and five of each of the newer AcrySof IOL models (MA60AC, SA60AT, TFNT00 and SN60WF) from 2014 to 2017. Furthermore, five Clareon (SY60WF) IOLs were put through the same accelerated aging procedure. The number of microvacuoles per square millimeter (MV/mm2) was determined in the central part of each IOL optic and compared between the groups. Results The mean number of MV was highest in the 1990s-manufacture Alcon acrylic IOLs, with 1289 (± 738) MV/mm2. The number decreased to 650 (± 101), 192 (± 105), 175 (± 112) and 47 (± 26) for MA60AC, SA60AT, TFNT00 and SN60WF, respectively. The lowest count was obtained in the Clareon group, with 1 (± 1) MV/mm2.
Conclusions A high number of glistenings was induced in the explanted IOLs from the 1990s. The propensity for glistening formation decreased considerably after that decade and now in current use. Even though in vitro glistening formation in today’s AcrySof material was low, the Clareon material was essentially glistenings-free.
Collapse
Affiliation(s)
- Qiang Wang
- David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany.,Department of Ophthalmology, Third Affiliated Hospital, Wenzhou Medical University, Ruian, Zhejiang, China
| | - Timur M Yildirim
- David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Sonja K Schickhardt
- David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Grzegorz Łabuz
- David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Ramin Khoramnia
- David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Patrick R Merz
- David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Hyeck-Soo Son
- David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Donald J Munro
- David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
| | - Elfriede Friedmann
- David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany.,Numerics and Mathematical Modeling, Institute of Mathematics, Faculty of Mathematics and Natural Sciences (FB10), University of Kassel, Kassel, Germany
| | - Gerd U Auffarth
- David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany.
| |
Collapse
|
18
|
Khoramnia R, Yildirim TM, Łabuz G, Mayer CS, Auffarth GU. [Opacification of intraocular lenses: laboratory and clinical findings]. Ophthalmologe 2020; 118:633-642. [PMID: 33188443 PMCID: PMC8260513 DOI: 10.1007/s00347-020-01259-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/22/2020] [Accepted: 10/14/2020] [Indexed: 12/24/2022]
Abstract
Hintergrund Das Spektrum der Komplikationen beim Einsatz von Intraokularlinsen (IOL) ist heute ein anderes als zur Zeit ihrer Einführung. Trübungen im IOL-Material werden vermehrt als Explantationsgrund in der Literatur beschrieben. Ziel der Arbeit Diese Arbeit soll einen Überblick über die verschiedenen Formen von IOL-Materialeintrübungen geben. Material und Methoden Die heute relevanten Formen von IOL-Materialeintrübungen und deren Auswirkungen auf die optische Abbildungsqualität wurden zusammengestellt. Ergebnisse und Diskussion Als Grund für eine Eintrübung steht bei hydrophilen IOL die Kalzifikation im Vordergrund, während bei hydrophoben IOL v. a. über die Entstehung sog. „Glistenings“ berichtet wird. Die meisten Materialeintrübungen beeinflussen verschiedene optische Parameter und führen zu einem erhöhten intraokularen Streulicht. Im Falle einer störenden Materialeintrübung besteht die einzige Therapieoption in einem Austausch der eingetrübten IOL.
Collapse
Affiliation(s)
- Ramin Khoramnia
- The David J Apple Center for Vision Research, Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
| | - Timur M Yildirim
- The David J Apple Center for Vision Research, Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Grzegorz Łabuz
- The David J Apple Center for Vision Research, Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Christian S Mayer
- The David J Apple Center for Vision Research, Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| | - Gerd U Auffarth
- The David J Apple Center for Vision Research, Universitäts-Augenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland
| |
Collapse
|