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Capsulorhexis ovaling and capsular bag stretch after rigid and foldable intraocular lens implantation: Experimental study in pediatric human eyes

Identifieur interne : 006C69 ( Main/Exploration ); précédent : 006C68; suivant : 006C70

Capsulorhexis ovaling and capsular bag stretch after rigid and foldable intraocular lens implantation: Experimental study in pediatric human eyes

Auteurs : Suresh K. Pandey [États-Unis] ; Liliana Werner [États-Unis] ; M. Edward Jr Wilson [États-Unis] ; Andrea M. Izak [États-Unis] ; David J. Apple [États-Unis]

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RBID : Pascal:04-0581867

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English descriptors

Abstract

Purpose: To compare the amount of capsulorhexis ovaling and capsular bag stretch produced by various intraocular lenses (lOLs) implanted in pediatric human eyes obtained post-mortem. Setting: David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, Salt Lake City, Utah, USA. Methods: In this nonrandomized comparative study, 16 pediatric human eyes obtained postmortem were divided into 2 groups: Eight eyes were obtained from children younger than 2 years (Group A), and 8 eyes were obtained from children older than 2 years (Group B). All eyes were prepared according to the Miyake-Apple posterior video technique. Six types of rigid and foldable posterior chamber lOLs manufactured from poly(methyl methacrylate) (single-piece), silicone (plate and loop haptics), and hydrophobic acrylic (single-piece and 3-piece AcrySof®, Alcon Laboratories) biomaterials were implanted. The capsulorhexis opening and capsular bag diameters were measured before IOL implantation and after in-the-bag IOL fixation with the haptics (or the main axis) at the 3 to 9 o'clock meridian. The percentage of ovaling of the capsulorhexis opening was calculated by noting the difference in the opening's horizontal diameter before and after IOL implantation. The percentage of capsular bag stretch was also calculated by noting the difference in the horizontal capsular bag diameter before and after IOL implantation. Results: All lOLs produced ovaling of the capsulorhexis opening and stretching of the capsular bag parallel to the IOL haptics. There were significant differences in capsulorhexis ovaling and capsular bag stretch (P<.001, analysis of variance) between the 6 IOL types in each group of eyes. The postimplantation difference was significant only between the single-piece hydrophobic acrylic IOL (AcrySof) and the other lOLs. The single-piece hydrophobic acrylic IOL was associated with significantly less capsulorhexis ovaling and capsular bag stretch in both groups (mean 12.06% ± 0.59% [SD] and 7.6% ± 1.47%, respectively). Conclusions: Modern rigid and foldable lOLs designed for the adult population implanted in the capsular bag of infants and children produced variable degrees of capsulorhexis ovaling and capsular bag stretch. The Miyake-Apple posterior video technique confirmed the well-maintained configuration of the capsular bag (with minimal ovaling) after implantation of a single-piece hydrophobic acrylic IOL because of its flexible haptic design.


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Le document en format XML

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<term>Capsulorhexis</term>
<term>Child</term>
<term>Child, Preschool</term>
<term>Experimental study</term>
<term>Eye</term>
<term>Humans</term>
<term>Implantation</term>
<term>Infant</term>
<term>Infant, Newborn</term>
<term>Intraocular lens</term>
<term>Lens Capsule, Crystalline (pathology)</term>
<term>Lens Implantation, Intraocular (adverse effects)</term>
<term>Lenses, Intraocular</term>
<term>Ophthalmology</term>
<term>Pediatrics</term>
<term>Postoperative Complications</term>
<term>Prosthesis Design</term>
<term>Surgery</term>
<term>Tissue Expansion</term>
<term>Treatment</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en">
<term>Lens Implantation, Intraocular</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en">
<term>Lens Capsule, Crystalline</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Capsulorhexis</term>
<term>Child</term>
<term>Child, Preschool</term>
<term>Humans</term>
<term>Infant</term>
<term>Infant, Newborn</term>
<term>Lenses, Intraocular</term>
<term>Postoperative Complications</term>
<term>Prosthesis Design</term>
<term>Tissue Expansion</term>
</keywords>
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<term>Capsulorhexis</term>
<term>Chirurgie</term>
<term>Lentille intraoculaire</term>
<term>Implantation</term>
<term>Etude expérimentale</term>
<term>Enfant</term>
<term>Nourrisson</term>
<term>Pédiatrie</term>
<term>Oeil</term>
<term>Ophtalmologie</term>
<term>Traitement</term>
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<div type="abstract" xml:lang="en">Purpose: To compare the amount of capsulorhexis ovaling and capsular bag stretch produced by various intraocular lenses (lOLs) implanted in pediatric human eyes obtained post-mortem. Setting: David J. Apple, MD Laboratories for Ophthalmic Devices Research, John A. Moran Eye Center, Salt Lake City, Utah, USA. Methods: In this nonrandomized comparative study, 16 pediatric human eyes obtained postmortem were divided into 2 groups: Eight eyes were obtained from children younger than 2 years (Group A), and 8 eyes were obtained from children older than 2 years (Group B). All eyes were prepared according to the Miyake-Apple posterior video technique. Six types of rigid and foldable posterior chamber lOLs manufactured from poly(methyl methacrylate) (single-piece), silicone (plate and loop haptics), and hydrophobic acrylic (single-piece and 3-piece AcrySof®, Alcon Laboratories) biomaterials were implanted. The capsulorhexis opening and capsular bag diameters were measured before IOL implantation and after in-the-bag IOL fixation with the haptics (or the main axis) at the 3 to 9 o'clock meridian. The percentage of ovaling of the capsulorhexis opening was calculated by noting the difference in the opening's horizontal diameter before and after IOL implantation. The percentage of capsular bag stretch was also calculated by noting the difference in the horizontal capsular bag diameter before and after IOL implantation. Results: All lOLs produced ovaling of the capsulorhexis opening and stretching of the capsular bag parallel to the IOL haptics. There were significant differences in capsulorhexis ovaling and capsular bag stretch (P<.001, analysis of variance) between the 6 IOL types in each group of eyes. The postimplantation difference was significant only between the single-piece hydrophobic acrylic IOL (AcrySof) and the other lOLs. The single-piece hydrophobic acrylic IOL was associated with significantly less capsulorhexis ovaling and capsular bag stretch in both groups (mean 12.06% ± 0.59% [SD] and 7.6% ± 1.47%, respectively). Conclusions: Modern rigid and foldable lOLs designed for the adult population implanted in the capsular bag of infants and children produced variable degrees of capsulorhexis ovaling and capsular bag stretch. The Miyake-Apple posterior video technique confirmed the well-maintained configuration of the capsular bag (with minimal ovaling) after implantation of a single-piece hydrophobic acrylic IOL because of its flexible haptic design.</div>
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<name sortKey="Pandey, Suresh K" sort="Pandey, Suresh K" uniqKey="Pandey S" first="Suresh K." last="Pandey">Suresh K. Pandey</name>
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