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植入具有改良方形边缘的亲水性丙烯酸人工晶状体的兔眼后囊膜混浊

Posterior capsule opacification in rabbit eyes implanted with hydrophilic acrylic intraocular lenses with enhanced square edge.

作者信息

Werner Liliana, Mamalis Nick, Pandey Suresh K, Izak Andrea M, Nilson Christian D, Davis Brandon L, Weight Christopher, Apple David J

机构信息

David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah 84132, USA.

出版信息

J Cataract Refract Surg. 2004 Nov;30(11):2403-9. doi: 10.1016/j.jcrs.2004.02.085.

Abstract

PURPOSE

To evaluate the development of posterior capsule opacification (PCO) after implantation of single-piece hydrophilic acrylic intraocular lenses (IOLs) with an enhanced square edge.

SETTING

John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.

METHODS

The standard 570H Centerflex (Rayner Ltd.) design was compared to 2 new designs with enhanced square edges: the 570E and the 570C. Ten IOLs of each type were implanted in a randomized manner by the same surgeon in 15 pigmented rabbits. After a follow-up of 3 weeks, the rabbits were killed and the eyes were analyzed from the posterior view. The intensity of central PCO, peripheral PCO, and Soemmering's ring formation was graded from 0 to 4. The area of Soemmering's ring was graded from 0 to 4 based on the number of quadrants involved. Other parameters analyzed were capsulorhexis coverage of the IOL edge and IOL centration and fixation. Results from the posterior view were complemented by histopathological evaluation.

RESULTS

Posterior capsule opacification was lowest in the 570C group, highest in the 570H group, and intermediate in the 570E group. There was a statistically significant difference between the 3 groups in peripheral PCO (P = .039). No significant difference was found between the groups in the other parameters analyzed. When cell ingrowth occurred with the 570H, it started at the optic-haptic junctions, as observed during the clinical follow-up and confirmed by gross and histopathological analyses.

CONCLUSIONS

The square optic edge is the most important IOL design feature for PCO prevention. However, it should be present for 360 degrees around the IOL optic to provide an effective barrier effect.

摘要

目的

评估植入具有改良方形边缘的单片式亲水性丙烯酸人工晶状体(IOL)后后囊膜混浊(PCO)的发展情况。

设置

美国犹他州盐湖城犹他大学约翰·A·莫兰眼科中心。

方法

将标准的570H Centerflex(雷纳有限公司)设计与两种具有改良方形边缘的新设计:570E和570C进行比较。由同一位外科医生以随机方式将每种类型的10枚IOL植入15只有色家兔眼中。随访3周后,处死家兔并从后视图对眼睛进行分析。中央PCO、周边PCO和索默林环形成的强度从0到4进行分级。根据受累象限数量,索默林环的面积从0到4进行分级。分析的其他参数包括IOL边缘的撕囊覆盖范围以及IOL的居中与固定情况。后视图的结果通过组织病理学评估进行补充。

结果

570C组的后囊膜混浊程度最低,570H组最高,570E组居中。三组在周边PCO方面存在统计学显著差异(P = .039)。在分析的其他参数方面,各组之间未发现显著差异。当570H出现细胞向内生长时,如临床随访期间观察到并经大体和组织病理学分析证实的那样,其始于视触觉交界处。

结论

方形光学边缘是预防PCO最重要的IOL设计特征。然而,它应围绕IOL光学部呈360度存在,以提供有效的屏障作用。

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