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Khoramnia R, Naujokaitis T, Łabuz G, Auffarth GU. Are There Patient-Relevant Differences in the Material Properties of Intraocular Lenses? Klin Monbl Augenheilkd 2024; 241:602-604. [PMID: 38776928 DOI: 10.1055/a-2261-1107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Affiliation(s)
- Ramin Khoramnia
- Augenklinik, Universitätsklinikum Heidelberg/Department of Ophthalmology, University Hospital of Heidelberg
| | - Tadas Naujokaitis
- Augenklinik, Universitätsklinikum Heidelberg/Department of Ophthalmology, University Hospital of Heidelberg
| | - Grzegorz Łabuz
- Augenklinik, Universitätsklinikum Heidelberg/Department of Ophthalmology, University Hospital of Heidelberg
| | - Gerd U Auffarth
- Augenklinik, Universitätsklinikum Heidelberg/Department of Ophthalmology, University Hospital of Heidelberg
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Wang Y, Wen C, Jing R, Yang Y, Qin Y, Qi T, Hu C, Bai X, Wu C, Pei C. Self-assembled coating with a metal-polyphenolic network for intraocular lens modification to prevent posterior capsule opacification. Biomed Mater 2024; 19:025011. [PMID: 38194710 DOI: 10.1088/1748-605x/ad1c9e] [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: 08/18/2023] [Accepted: 01/09/2024] [Indexed: 01/11/2024]
Abstract
Posterior capsule opacification (PCO) is a main complication after cataract surgery and intraocular lens (IOLs) implantation and is attributed to residual lens epithelial cells (LECs) migrating to the IOL surface and posterior capsules. IOL surface modification has been a newly-developing research filed in recent years; however, the applicability and economical acquisition of modified materials remain unsolved. In this study, we first applied a metal-polyphenolic network coating with a self-assembly technique on the IOL surface by using tannic acid (TA) combined with AlCl3, which are easily acquire and applying on the IOL surface to solve the IOL transmittance affair. Using wound healing and Transwell assay to verify AZD0364 inhibits cell migration (P< 0.05), the lipopolysaccharide-induced macrophage inflammation model to verify pterostilbene (PTE) inhibits the inflammatory reaction (P< 0.01). By optimizes its self-assembly coating parameters and calculating its drug release kinetics, we successfully loaded these two drugs on the coating, named TA (AZD0364/PTE) IOL. Its surface morphology characteristics were analyzed by scanning electron microscope, x-ray photoelectron spectrometer and water contact angle. The optical performance was carefully investigated by optical instruments and equipment (n= 3). Thein vitroresults showed that TA (AZD0364/PTE) IOL can significantly inhibit cell adhesion and acute inflammation (n= 3,P< 0.0001). Importantly, afterin vivoimplantation for 28 d with eight rabbits PCO models in two groups, the TA (AZD0364/PTE) IOL group maintained clear refracting media and decreased the inflammatory reaction compared with the original IOL group (P< 0.05). This study provides a new applicable and economical strategy for preventing PCO and offers a reference for the next generation of IOLs that benefit cataract patients.
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Affiliation(s)
- Yunqing Wang
- Department of Ophthalmology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, People's Republic of China
| | - Chan Wen
- Department of Ophthalmology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, People's Republic of China
| | - Ruihua Jing
- Department of Ophthalmology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, People's Republic of China
| | - Yunfei Yang
- Department of Ophthalmology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, People's Republic of China
| | - Yazhou Qin
- Department of Ophthalmology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, People's Republic of China
| | - Tiantian Qi
- Department of Ophthalmology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, People's Republic of China
| | - Conghui Hu
- Department of Ophthalmology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, People's Republic of China
| | - Xinshan Bai
- Department of Ophthalmology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, People's Republic of China
| | - Changrui Wu
- Department of Ophthalmology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, People's Republic of China
| | - Cheng Pei
- Department of Ophthalmology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, People's Republic of China
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Bhattacharjee H, Das D, Bhattacharjee K, Buragohain S, Javeri H. Transmittance characteristics of transparent hydrophobic acrylic foldable intraocular lenses that were in vivo for a prolonged period of time: A UV visible spectrophotometric study. Indian J Ophthalmol 2023; 71:3663-3668. [PMID: 37991301 PMCID: PMC10788741 DOI: 10.4103/ijo.ijo_273_23] [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: 01/29/2023] [Revised: 06/22/2023] [Accepted: 07/03/2023] [Indexed: 11/23/2023] Open
Abstract
PURPOSE To record experimental data on the spectral transmittance characteristics of transparent hydrophobic acrylic foldable IOLs, which were in vivo for a prolonged period of time and explanted under clinical indications and also to compare the data with that of corresponding control and crystalline lens along with review of the relevant literature. METHOD Material and make of each of the explanted intraocular lenses (IOLs) as well as pre-explantation clinical status of the eyes were confirmed from the medical record. The transmittance of wavelength from 185 to 900 nm of each of the selected IOLs was measured using Shimadzu UV 2600 UV visible (UV-Vis) spectrophotometer in double-beam configuration and probe version 2.16 software. The data obtained were statistically analyzed. RESULTS The mean transmittance of 12 clinically explanted IOLs at spectral range 300-700 nm was 49.5% ± SD 6.9%. This value was 10% and 38% less than the corresponding clear (59% ± SD 0.4%) and yellow (87.5% ± SD 0.4%) control, respectively. The mean transmittance of the analytes in the UV range was 43.3 ± SD 6.9%, and it was almost similar to the control. The data showed wide variations without good correlation, and it matches with the human crystalline lens at the age range of 50-60 years. All eyes were otherwise healthy, and none had age-related macular degeneration. CONCLUSION In comparison with fresh IOL with a yellow filter, light transmittance at the spectral range 300-700 nm was found decreased in all the IOLs, which were in vivo for an average period of 12.25 ± 4.4 years. All IOLs transmitted variable amounts of UV radiation. More data are required for further analysis on the subject.
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Affiliation(s)
| | - Dipankar Das
- Department of Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | | | | | - Henal Javeri
- Department of Ophthalmology, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
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Itoh K. Stainability of Acrylic Intraocular Lens With Brilliant Blue G: An In Vitro Study. Am J Ophthalmol 2023; 254:104-113. [PMID: 37406844 DOI: 10.1016/j.ajo.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE To evaluate the stainability of several acrylic intraocular lens (IOLs) with Brilliant Blue G (BBG) in vitro. DESIGN Clinically relevant, laboratory, experimental study. METHODS LS313MF15 as a hydrophilic acrylic IOL and X-70, W60R, CP2.2R, YP2.2R, XC1, and XY1 as hydrophobic acrylic IOLs were included in this study. Prepared acrylic IOLs were evaluated for staining via immersion for different periods in BBG solution with adjusted concentrations. In cases where IOLs were stained blue, the sustained release of BBG and IOL cross-sectional images were evaluated, as well as changes in the optical properties of the IOLs via spectrophotometry. RESULTS All acrylic IOLs were stained with BBG in a BBG concentration- and staining time-dependent manner, with almost no sustained release of BBG observed. Lenses with a higher water content exhibited more pronounced staining, and BBG penetrated into the IOLs. A decrease in light transmittance with a peak wavelength of 610 to 620 nm was observed in blue-stained IOLs. LS313MF15 was markedly blue stained even with a short period of staining. CONCLUSIONS Any acrylic IOL can be stained with BBG, but hydrophilic IOLs are particularly susceptible to blue staining. Precautions should be taken in surgeries requiring the use of BBG staining, and efforts should be made to ensure that BBG components are sufficiently washed out intraoperatively.
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Affiliation(s)
- Kaku Itoh
- From the Departments of Ophthalmology, Muroran City General Hospital, Muroran City, Hokkaido, Japan (K.I.).
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Iannetta D, Febbraro S, Valsecchi N, Moramarco A, Fontana L. FIL SSF intraocular lens opacification after pars plana vitrectomy with gas tamponade for traumatic lens luxation and retinal detachment: a case report and literature review. BMC Ophthalmol 2023; 23:383. [PMID: 37743488 PMCID: PMC10519003 DOI: 10.1186/s12886-023-03126-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/07/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND To report a case of sutureless scleral-fixated hydrophilic intraocular lens (FIL SSF IOL, Soleko, Italy) opacification following pars plana vitrectomy surgery using sulfur hexafluoride (SF6) for traumatic lens luxation associated with retinal detachment. CASE PRESENTATION A 77-year-old woman was referred to our emergency department after blunt trauma in her right eye. At the ophthalmic evaluation, visual acuity was hand movement, biomicroscopy showed pseudoexfoliation syndrome and a traumatic lens luxation in the vitreous chamber. The patient underwent pars plana vitrectomy, subluxated cataract explantation, and FIL SSF IOL implant. During surgery, an inferior retinal detachment was encountered, requiring 20% SF6 gas tamponade. No adverse events were encountered. One month postoperatively, visual acuity (BCVA) improved to 0,3 logMAR. At the 3-month follow-up, the patient presented with BCVA of 0,5 logMAR, and biomicroscopy showed a minimal IOL opacification. Six months postoperatively, BCVA decreased to 1.0 logMAR, and diffuse, IOL opacification was noted at slit lamp examination. The patient refused any other surgical intervention for IOL exchange. CONCLUSIONS Although hydrophilic IOL opacification gas related is known, to the best of our knowledge, this is the first case reported in the literature of FIL SSF IOL opacification after pars plana vitrectomy with gas tamponade for retinal detachment.
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Affiliation(s)
- Danilo Iannetta
- Ophthalmology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum University of Bologna, Bologna, Italy.
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9 Bologna, Postal code, 40138, Bologna, Italy.
| | - S Febbraro
- Ophthalmology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9 Bologna, Postal code, 40138, Bologna, Italy
| | - N Valsecchi
- Ophthalmology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9 Bologna, Postal code, 40138, Bologna, Italy
| | - A Moramarco
- Ophthalmology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9 Bologna, Postal code, 40138, Bologna, Italy
| | - L Fontana
- Ophthalmology Unit, Dipartimento di Scienze Mediche e Chirurgiche, Alma Mater Studiorum University of Bologna, Bologna, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9 Bologna, Postal code, 40138, Bologna, Italy
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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.
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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
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Xie J, Zang X, Mao S, Sun J, Liu T, Dai Y. Late postoperative opacification of a new type hydrophilic acrylic intraocular lens. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2023; 3:134-140. [PMID: 37846363 PMCID: PMC10577844 DOI: 10.1016/j.aopr.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 10/18/2023]
Abstract
Background To report the clinical consequences and laboratory characteristics of late postoperative opacification of a hydrophilic acrylic intraocular lens (US-860UV IOL) as well as the prognosis of IOL replacement. Methods Forty medical records (42 eyes) of patients with US-860UV IOL opacification reporting decreased or lost vision who underwent IOL explantation between 2017 and 2019 were reviewed. Explanted IOLs were analyzed by slit-lamp examination, confocal microscopy, scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) at the Shandong Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University, and Qingdao University of Science and Technology, Qingdao, China. Results The mean age of the 40 patients was 74.83 ± 7.57 (63-92) years. The mean interval between cataract surgery and diagnosis of opacification was 32.38 ± 8.76 (17-48) months. Systemic diseases were found without statistical correlations, the most frequent being arterial hypertension, coronary heart disease, and diabetes mellitus. Visual acuity improved from 1.42 ± 1.03 to 0.31 ± 0.16 (logMAR) after IOL replacement. SEM, EDS and alizarin red staining showed uniformly distributed, diffuse, milk-white opacification, with calcium and phosphorus deposits on the optic and haptic surfaces that could be dissolved in 1% HCl. Conclusions Calcium and phosphorus deposition was the main cause of hydrophilic acrylic US-860UV IOL opacification. IOL replacement can safely and effectively improve the visual acuity of patients.
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Affiliation(s)
- Jin Xie
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong, China
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong, China
| | - Xinyi Zang
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong, China
- Weifang Medical University, Weifang, Shandong, China
| | - Shilan Mao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong, China
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong, China
- Shandong First Medical University, Jinan, Shandong, China
| | - Jie Sun
- People's Hospital of Yinan, Linyi, Shandong, China
| | - Ting Liu
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong, China
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong, China
| | - Yunhai Dai
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao, Shandong, China
- Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong, China
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Naujokaitis T, Khoramnia R, Łabuz G, Choi CY, Auffarth GU, Tandogan T. Imaging Function and Relative Light Transmission of Explanted Opacified Hydrophilic Acrylic Intraocular Lenses. Diagnostics (Basel) 2023; 13:diagnostics13101804. [PMID: 37238287 DOI: 10.3390/diagnostics13101804] [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: 03/29/2023] [Revised: 05/14/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
We evaluated the influence of intraocular lens (IOL) opacification on the optical performance of explanted hydrophilic acrylic IOLs. We performed a laboratory analysis of 32 Lentis LS-502-1 (Oculentis GmbH, Berlin, Germany) IOLs, explanted due to opacification, in comparison with six clear unused samples of the same IOL model. Using an optical bench setup, we obtained modulation transfer function (MTF), Strehl ratio, two-dimensional MTF, and United States Air Force (USAF) chart images. In addition, we assessed light transmission through the IOLs. The MTF values of opacified IOLs at 3-mm aperture were similar to those of clear lenses, with the median (interquartile range) values of 0.74 (0.01) vs. 0.76 (0.03) at the spatial frequency of 50 line pairs per millimeter in clear and opacified IOLs, respectively. The Strehl ratio of opacified lenses was not lower than that of clear lenses. The USAF-chart analysis showed a considerable reduction in brightness in opacified IOLs. The median (interquartile range) relative light transmission of opacified IOLs in comparison to clear lenses was 55.6% (20.8%) at the aperture size of 3 mm. In conclusion, the explanted opacified IOLs had comparable MTF values to those of clear lenses but significantly reduced light transmission.
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Affiliation(s)
- Tadas Naujokaitis
- The David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Ramin Khoramnia
- The David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Grzegorz Łabuz
- The David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Chul Young Choi
- The David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea
| | - Gerd U Auffarth
- The David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Tamer Tandogan
- The David J. Apple Center for Vision Research, Department of Ophthalmology, University of Heidelberg, 69120 Heidelberg, Germany
- Augenklinik Pallas, 4600 Olten, Switzerland
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Bellucci C, Mora P, Tedesco SA, Gandolfi S, Bellucci R. Refractive Outcome and 5-Year Capsulotomy Rate of Hydrophobic and Hydrophilic IOLs with Similar Optical Design: A Contralateral Study. Ophthalmol Ther 2023; 12:1387-1395. [PMID: 36602719 PMCID: PMC9815056 DOI: 10.1007/s40123-022-00646-0] [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: 11/22/2022] [Accepted: 12/21/2022] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION To compare the short-term visual and aberrometric outcomes and the long-term capsulotomy incidence in a cohort of patients receiving IOLs with similar structural profile but with a hydrophobic matrix in one eye (PHOB group) and a hydrophilic matrix in the other one (PHIL group). METHODS In this retrospective, contralateral study, 26 patients sequentially undergoing phacoemulsification were implanted as mentioned above. Refraction and aberrometry were evaluated 6 months after surgery. For the quality of vision, the Hartmann-Shack optical aberration, Double-Pass Modulation Transfer Function (MTF), contrast sensitivity, and dysphotopsia results were compared. Capsulotomy was ascertained and dated by medical chart revision or phone call. RESULTS All the considered quantitative and qualitative visual parameters tested statistically comparable between PHIL and PHOB group. After 5 years, four patients (16.7%) in the PHOB group and five patients (20.8%) in the PHIL group underwent a Nd:YAG posterior capsulotomy (P > 0.5). CONCLUSION In this contralateral comparative study, the hydrophobic and hydrophilic matrix of the IOL similarly influenced the visual and aberrometric outcomes. Also the long-term laser capsulotomy incidence did not statistically differ between groups. The posterior IOL profile, rather than matrix hydrophilia, could consistently influence the posterior capsule opacification.
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Affiliation(s)
- Carlo Bellucci
- Ophthalmology Unit, Department of Medicine and Surgery, University Hospital of Parma, University of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Paolo Mora
- Ophthalmology Unit, Department of Medicine and Surgery, University Hospital of Parma, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Salvatore A Tedesco
- Ophthalmology Unit, Department of Medicine and Surgery, University Hospital of Parma, University of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Stefano Gandolfi
- Ophthalmology Unit, Department of Medicine and Surgery, University Hospital of Parma, University of Parma, Via Gramsci 14, 43126, Parma, Italy
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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.
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Randomized multicenter trial to assess posterior capsule opacification and glistenings in two hydrophobic acrylic intraocular lenses. Sci Rep 2023; 13:2822. [PMID: 36805494 PMCID: PMC9938215 DOI: 10.1038/s41598-023-29855-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 02/11/2023] [Indexed: 02/19/2023] Open
Abstract
To evaluate the long-term posterior capsule opacification (PCO) formation, and glistening rate of the HOYA Vivinex (XY1) IOL compared to Alcon AcrySof (SN60WF). In this prospective, multicentric, randomized, paired-eye, open-label study, we included 87 subjects that underwent cataract surgery with IOL implantation, with 67 patients completing the 3-year follow-up. The completer population consisted of 32 subjects implanted with XY1 and 35 implanted with SN60WF. Primary endpoints consisted of the evaluation of glistenings and measurement of PCO. Secondary outcomes included Best Corrected Distance Visual Acuity (BCVA), Contrast Acuity (CA), uncorrected visual acuities, subjective refraction, medical and lens complication rates, adverse events, and optical/visual symptoms. Follow-up visits occurred at 6-months, 1-, 2- and 3-years. At 3-years follow-up, mean PCO score was 0.121 ± 0.193 for eyes implanted with Vivinex versus 0.239 ± 0.463 for AcrySof (p = 0.026). The Vivinex IOL showed statistically significantly lower glistening occurrence through 3-years postoperatively (0.14 ± 0.26) compared to AcrySof (1.79 ± 1.43; p < 0.0001). Postoperative visual acuities improved from baseline in both IOL groups (p < 0.0001), and remained stable through the 3-year follow-up period. Eyes implanted with a HOYA Vivinex IOL exhibited significantly lower occurrence of glistening at 3-years versus Alcon AcrySof (p < 0.0001). Incidence of PCO was very low and comparable in both Vivinex and AcrySof eyes.
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Specifying Risk of Intraocular Lens Opacification After Endothelial Keratoplasty for Different Intraocular Lens Models: A Retrospective Monocentric Cohort Study. Cornea 2022:00003226-990000000-00119. [PMID: 36633939 DOI: 10.1097/ico.0000000000003087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/18/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE The aims of this study were to calculate the specific risk of opacification for different intraocular lens (IOL) models and to determine whether differences exist, even between lenses made of similar acrylic materials. METHODS This is a retrospective cohort study of all patients who underwent endothelial keratoplasty (EK), either after or in conjunction with cataract surgery, from June 2009 to October 2020 at Fundación Jiménez Díaz Hospital. RESULTS Three hundred seventy-two eyes of 308 patients with a median follow-up of 856 days [interquartile range (IQR): 384-1570] were included, of which 128 IOLs were hydrophobic, 120 hydrophilic, and 124 unknown. 12.9% of IOLs opacified after a median of 466 days (IQR: 255-743). Visual acuity (VA) was significantly lower in the opacified IOL group [0.51 (IQR: 0.36-1.13)] compared with the nonopacified group [0.22 (IQR: 0.11-0.65)] ( P < 0.001). IOL explantation and exchange was performed in 10 eyes, in which VA improved markedly, from 1.75 (IQR: 0.99-3.00) to 0.60 (IQR: 0.36-0.86) ( P = 0.004). IOL material and opacification events were not independent ( P < 0.001). Significant differences were found between the Akreos ADAPT AO and MI60P models and the Asphina 409M model ( P = 0.022). No significant differences were found in the opacification ratio for hydrophilic IOLs in the clinical diagnosis ( P = 0.11), the type of EK ( P = 0.25), the rebubbling rate ( P = 0.44), or the tamponade used ( P = 0.36). CONCLUSIONS Hydrophilic lenses should be avoided in patients at risk of requiring EK. It is important to know the probability of opacification of each IOL model to balance risk and benefits when planning an EK procedure because not all lenses opacify equally. Opacification is an unwanted event with a negative impact on VA, making IOL explantation and exchange the only viable treatment, although one that is not without risks.
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Britz L, Schickhardt SK, Yildirim TM, Auffarth GU, Lieberwirth I, Khoramnia R. Development of a standardized in vitro model to reproduce hydrophilic acrylic intraocular lens calcification. Sci Rep 2022; 12:7685. [PMID: 35538104 PMCID: PMC9090772 DOI: 10.1038/s41598-022-11486-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 04/07/2022] [Indexed: 11/20/2022] Open
Abstract
Opacification through calcification of hydrophilic acrylic intraocular lenses (IOL) is a severe complication after cataract surgery. Causing symptoms that range from glare through to severe vision loss, the only effective therapy is explantation of the opacified IOL so far. Although IOL calcification is a well-described phenomenon, its pathogenesis is not fully understood yet. The purpose of the current study was to develop a laboratory model to replicate IOL calcification. Calcification could be reproduced using a horizontal electrophoresis and aqueous solutions of calcium chloride and disodium hydrogen phosphate. The analysis of the in vitro calcified IOLs was performed using light microscopy, Alizarin Red and Von Kossa staining, scanning electron microscopy, energy dispersive x-ray spectroscopy and electron crystallography using transmission electron microscopy and electron diffraction. The presented laboratory model could be used to identify hydrophilic IOLs that are at risk to develop calcification and to assess the influence of associated risk factors. In addition, it can serve as a research tool to further understand this pathology.
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Affiliation(s)
- Leoni Britz
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Eye Clinic Heidelberg, University of Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - Sonja Katrin Schickhardt
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Eye Clinic Heidelberg, University of Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - Timur Mert Yildirim
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Eye Clinic Heidelberg, University of Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - Gerd Uwe Auffarth
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Eye Clinic Heidelberg, University of Heidelberg, INF 400, 69120, Heidelberg, Germany.
| | - Ingo Lieberwirth
- Department of Physical Chemistry of Polymers, Max Planck Institute for Polymer Research, Mainz, Germany
| | - Ramin Khoramnia
- The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Eye Clinic Heidelberg, University of Heidelberg, INF 400, 69120, Heidelberg, Germany
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Grzybowski A, Zemaitiene R, Markeviciute A, Tuuminen R. Should We Abandon Hydrophilic Intraocular Lenses? Am J Ophthalmol 2022; 237:139-145. [PMID: 34843687 DOI: 10.1016/j.ajo.2021.11.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/02/2021] [Accepted: 11/16/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE To characterize the features of hydrophilic intraocular lenses (IOLs) important in the clinical context of expected prolonged duration time of the IOL within the eye. DESIGN Perspective. METHODS Discussion includes possible factors and mechanisms associated with hydrophilic IOLs' susceptibility to calcification and posterior capsule opacification (PCO) formation. RESULTS Results of recently reported studies show that particular surgeries, such as pars plana vitrectomy, Descemet stripping (automated) endothelial keratoplasty, and Descemet membrane endothelial keratoplasty with intraocular gas or air injection, might predispose the calcification process of hydrophilic IOLs, leading to a significant decrease in visual quality and possibly explantation of the IOL. Hydrophilic IOLs are more susceptible than hydrophobic IOLs to PCO formation, which is the most common of late postoperative complications that are associated with significant side effects. CONCLUSIONS We believe that all patients should be informed about the higher risk of calcification and PCO associated with hydrophilic IOLs. We also recommend limiting the use of hydrophilic acrylic IOLs during cataract surgery, especially when it is combined with pars plana vitrectomy or endothelial keratoplasty, and in patients with endothelial diseases who will probably require operation on it in the future.
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Affiliation(s)
- Andrzej Grzybowski
- From the Department of Ophthalmology, University of Warmia and Mazury, (A.G.), Olsztyn; Institute for Research in Ophthalmology (A.G.), Poznan, Poland.
| | - Reda Zemaitiene
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences (R.Z., A.M.), Kaunas, Lithuania
| | - Agne Markeviciute
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences (R.Z., A.M.), Kaunas, Lithuania
| | - Raimo Tuuminen
- Helsinki Retina Research Group, University of Helsinki (R.T.), Helsinki; Department of Ophthalmology, Kymenlaakso Central Hospital (R.T.), Kotka, Finland
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Renzi-Hammond LM, Hammond BR. Blue-light filtering intraocular implants and darker irises reduce the behavioral effects of higher-order ocular aberrations. Curr Eye Res 2022; 47:753-758. [PMID: 35179418 DOI: 10.1080/02713683.2022.2025844] [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: 11/03/2022]
Abstract
PURPOSE Higher order ocular aberrations (e.g., entopic scatter) arising from cornea and lens, decreases retinal image contrast by dispersing part of the image-forming optics over a broad retinal surface. Selective filtering of the light that is most susceptible to aberration (high-energy "blue" light) may reduce some of the behavioral effects. This was tested by comparing the performance of a blue-light filtering (BLF) vs a clear intraocular lens implant (IOL). MATERIALS AND METHODS 52 participants with IOL (BLF: AlconSN60AT; clear: AlconSA60AT; N = 98 test eyes; M = 67.33 ± 7.48 years; 58.8% Female; 25.5% non-White) were recruited. Our outcome measure was based on the minimum resolvable distance between two points of light (two-point thresholds), formed using broadband xenon or isolated short-wave energy (425 nm). Iris color was measured by visual inspection and comparison against standard images. RESULTS In the broadband condition, patients with BLF IOL had smaller two-point thresholds (M = 17.17 ± 5.71 mm; F[1,48]=2.60; p = 0.045) than clear controls (M = 20.93 ± 10.22 mm). Similar improvements were found in the short-wave condition (MBLF=17.02 ± 5.30; Mclear=21.42 ± 10.99; p = 0.04). In the contralateral broadband comparison, eyes with the BLF had significantly smaller two-point thresholds (M = 18.10 ± 10.47 mm; t=-2.90, p < 0.001) than the clear IOL (M = 20.89 ± 10.61 mm). Similar effects were seen in the short-wave condition (MBLF=18.23 ± 9.88; Mclear=21.06 ± 10.47; p = 0.001). Darker iris color was related to reduced scatter across IOL types, in both shortwave (F[2,48]=4.62, p = 0.02) and broadband (F[2,48]=5.27, p = 0.009) conditions. CONCLUSIONS Anterior screening, be it by a darker iris or a BLF IOL, is directly related to decreases in two-point light thresholds.
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Affiliation(s)
- Lisa M Renzi-Hammond
- Institute of Gerontology; Department of Health Promotion and Behavior; University of Georgia, Athens, GA 30602; United States;
| | - Billy R Hammond
- Vision Sciences Laboratory; Behavioral and Brain Sciences Program; Department of Psychology; University of Georgia; Athens, GA 30602; United States;
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Zeng Y, Liang M, Fan C, Xu S, Liu F, Zhou X, Tan X, Wang X. Opacification of refractive bifocal intraocular lens in one month: Three case reports. Medicine (Baltimore) 2022; 101:e28757. [PMID: 35119034 PMCID: PMC8812625 DOI: 10.1097/md.0000000000028757] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/10/2022] [Accepted: 01/17/2022] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Multifocal intraocular lenses (IOLs) are used widely. However, the discovery of LS-313 MF15/30 (Oculentis B.V.) opacity during surgery has not yet been reported. This article reports 3 cases of LS-313 MF15/30 (Oculentis B.V.) IOL opacity found during cataract surgery implantation within 1 month. PATIENT CONCERNS Three patients underwent cataract surgery, and opacification of their IOL (LS-313 MF15/30, Oculentis B.V.) was found intraoperatively. DIAGNOSIS The patient was diagnosed with a postoperative intraocular opacity. INTERVENTIONS In case 1, the surgeon scrubbed the IOL with intraocular perfusion fluid and a gelatin sponge swab to reduce opacity in the central optical area of the IOL and then implanted it into the capsule bag. In case 2, the surgeon used the infusion-aspiration polishing mode for cleaning. To avoid IOL wear and bag damage, washing was stopped when turbidity in the center of the optical area was reduced. In case 3, we learned from our previous experience that the surgeon cut the IOL into 2 pieces and moved it out at the main incision, which was replaced and implanted with a brand new IOL, after the implanted IOL was again found cloudy. OUTCOMES In case 1, more than 10 months after the surgery, the IOL was restored to transparency, no obvious eye discomfort was noted, and uncorrected visual acuity was 20/25. In case 2, the patient's IOL surrounding area was still partially turbid after more than 10 months of follow-up. In case 3, the patient's uncorrected visual acuity on postoperative day 1 was 20/20, and the best-corrected visual acuity was 20/20. LESSON There are many reasons for the opacification of the IOL. In addition to the patient's own factors, the material, production, and packaging of the IOL, as well as the influence of external environmental temperature, the influence of the IOL implant instrument should not be ignored and needs to be considered.
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Dragnea DC, Tru Latin Small Letter T With Comma Below A RN, Goemaere J, Tassignon MJ, Dhubhghaill SN. Intraocular Bag-in-the-Lens Exchange: Indications, Outcomes and Complications. J Cataract Refract Surg 2021; 48:568-575. [PMID: 34417783 DOI: 10.1097/j.jcrs.0000000000000787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/06/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To report the indications, outcomes, and complications regarding the Bag-in-the-lens (BIL) intraocular lens (IOL) exchanges over a period of 13 years in a tertiary ophthalmologic centre. SETTING Department of Ophthalmology of the University Hospital of Antwerp (UZA). DESIGN Observational retrospective study. PATIENTS AND METHODS Between 2003 and 2020, 12 176 patients were operated using the BIL technique. We included adult patients who underwent an intraocular BIL exchange and recorded the demographics, indications, outcomes, and complications. RESULTS Fifty-nine eyes of 59 patients who underwent a BIL exchange between 2007 and 2020 were included (0.48%). The mean age was 61.15 ±13.53 years. The mean time between primary surgery and IOL exchange was 25.73 ± 41.88 months. The main indication for explantation was refractive surprise mostly related to the patients' risk factors e.g. preoperative corneal and refractive surgery. The mean preoperative uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were 0.36 ± 0.24 and 0.79 ± 0.24 respectively. The postoperative 1 month-UDVA and CDVA were 0.66 ± 0.28 and 0.86 ± 0.19 respectively. The improvement in UDVA was statistically significant (<0.0001). The most common peroperative complication was damage to the anterior hyaloid in 9 eyes (15%), which did not prohibit reimplantation of a secondary BIL. CONCLUSIONS BIL to BIL exchange is an viable and successful technique that provides good refractive results with few, manageable complications. Because of the tertiary profile of our centre with referral of complex cases, BIL was our preferred IOL in patients at risk of postoperative refractive surprise.
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Affiliation(s)
- Diana Carmen Dragnea
- Department of Ophthalmology, Antwerp University Hospital, Wilrijk, Belgium Department of Medicine, University of Antwerp, Wilrijk, Belgium University of Medicine and Pharmacy, Târgu Mure[Latin Small Letter s with comma below], Romania
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