Eldred Julie A, Spalton David J, Wormstone I Michael
School of Biological Sciences, University of East Anglia, Norwich, United Kingdom.
School of Biological Sciences, University of East Anglia, Norwich, United Kingdom King Edward VII Hospital, London, United Kingdom.
Invest Ophthalmol Vis Sci. 2014 Sep 18;55(11):7057-64. doi: 10.1167/iovs.14-15302.
During cataract surgery an IOL is placed within the capsular bag. Clinical studies show that IOLs with a square edge profile and complete contact between the IOL and the anterior capsule (AC) are currently the best way to prevent posterior capsule opacification (PCO). This has been challenged by recent clinical and experimental observations, which suggest that if the capsular bag is kept open with separation of contact between the AC and posterior capsule (PC) by an "open-bag device" PCO is dramatically reduced. Therefore, the current study set out to evaluate the putative merits of an open-bag IOL (Anew Zephyr) in a human capsular bag model.
An in vitro organ culture model using the bag-zonular-ciliary body complex isolated from fellow human donor eyes was prepared. A capsulorhexis and lens extraction were performed, and an Alcon Acrysof IOL or Anew Zephyr IOL implanted. Preparations were secured by pinning the ciliary body to a silicone ring and maintained in 6 mL Eagle's minimum essential medium (EMEM) or EMEM supplemented with 2% vol/vol human serum (HS) and 10 ng/mL TGF-β2 for 28 days. Cell growth and capsular modifications were monitored with phase-contrast and modified dark-field microscopy.
In serum-free EMEM culture conditions, cells were observed growing onto the PC of preparations implanted with an Anew Zephyr IOL, but this was retarded relative to observations in match-paired capsular bags implanted with an Alcon Acrysof IOL. In the case of cultures maintained in 2% HS-EMEM plus TGF-β2, the movement on to the PC was again delayed with the presence of an Anew Zephyr IOL. Differences in the degree of growth on the PC and matrix modifications were apparent with the different donors, but in each case the match-paired Alcon Acrysof implanted bag exhibited significantly greater coverage and modification of the capsule.
The Anew Zephyr open-bag IOL performs consistently better than the Alcon Acrysof IOL in the human capsular bag model. We propose that the benefits observed with the Anew Zephyr result from a reduction in growth factor levels available within the capsular bag and a barrier function imposed by the ring haptic.
在白内障手术中，人工晶状体（IOL）被放置在囊袋内。临床研究表明，具有方形边缘轮廓且IOL与前囊（AC）完全接触的IOL是目前预防后囊混浊（PCO）的最佳方法。最近的临床和实验观察对这一观点提出了挑战，这些观察表明，如果通过“开放囊袋装置”使囊袋保持开放，AC与后囊（PC）之间的接触分离，PCO会显著减少。因此，本研究旨在评估开放囊袋IOL（Anew Zephyr）在人囊袋模型中的假定优点。
使用从人类供体眼分离出的囊膜 - 悬韧带 - 睫状体复合体建立体外器官培养模型。进行撕囊和晶状体摘除，并植入爱尔康Acrysof IOL或Anew Zephyr IOL。通过将睫状体固定在硅胶环上固定标本，并在6 mL伊格尔最低限度基本培养基（EMEM）或补充有2%体积/体积人血清（HS）和10 ng/mL转化生长因子 - β2的EMEM中维持28天。用相差显微镜和改良暗视野显微镜监测细胞生长和囊膜变化。
在无血清EMEM培养条件下，观察到植入Anew Zephyr IOL的标本的PC上有细胞生长，但相对于植入爱尔康Acrysof IOL的配对囊袋中的观察结果，这种生长受到了抑制。在含有2% HS - EMEM加转化生长因子 - β2的培养物中，Anew Zephyr IOL的存在再次延迟了细胞向PC的移动。不同供体的PC上的生长程度和基质变化存在差异，但在每种情况下，配对植入爱尔康Acrysof的囊袋对囊膜的覆盖和变化都明显更大。
在人囊袋模型中，Anew Zephyr开放囊袋IOL的表现始终优于爱尔康Acrysof IOL。我们认为，Anew Zephyr观察到的益处源于囊袋内可用生长因子水平的降低以及环形襻施加的屏障功能。
