Pathological assessment of complications with asymmetric or sulcus fixation of square-edged hydrophobic acrylic intraocular lenses
Identifieur interne : 001629 ( Pmc/Checkpoint ); précédent : 001628; suivant : 001630Pathological assessment of complications with asymmetric or sulcus fixation of square-edged hydrophobic acrylic intraocular lenses
Auteurs : Kevin R. Kirk [États-Unis] ; Liliana Werner [États-Unis] ; Ryan Jaber [États-Unis] ; Susan Strenk [États-Unis] ; Lawrence Strenk [États-Unis] ; Nick Mamalis [États-Unis]Source :
- Ophthalmology [ 0161-6420 ] ; 2012.
Abstract
One-piece hydrophobic acrylic intraocular lenses (IOLs) are not indicated for sulcus fixation because of complications, such as uveitis-glaucoma-hyphema syndrome. Similar complications may also be observed with 3-piece lenses having a square optic edge on the anterior surface. The objective of this study was to provide pathological evidence of complications related to out-of-the-bag fixation of 1-piece or 3-piece hydrophobic acrylic IOLs with anterior and posterior square optic edges.
Comparative case series with pathology.
559 pseudophakic cadaver eyes obtained from eye banks within the United States, implanted with different IOLs.
Anterior segment scanning of whole eyes with a high-frequency ultrasound system, or with a high-resolution anterior segment magnetic resonance imaging, followed by gross examination. Selected eyes were processed for complete histopathological analysis; some of them were explanted before histopathology to allow for direct light microscopic evaluation of the lenses.
Findings from imaging, gross, and histopathological evaluation that could be related to out-of-the-bag fixation of the lenses.
256 eyes were implanted with hydrophobic acrylic IOLs with anterior and posterior square optic edges; 18 of them exhibiting asymmetric or sulcus IOL fixation (six 1-piece, and twelve 3-piece IOLs) underwent complete histopathological evaluation and were compared to the contralateral eyes with symmetric in-the-bag IOL implantation. Pathological findings were composed of IOL decentration and tilt, pigmentary dispersion within the anterior segment and on the IOL surface, iris transillumination defects, iris changes including vacuolization/disruption/loss of the pigmented layer, iris thinning, and iris atrophy, as well as synechiae and loop erosion in the case of 3-piece lenses. Findings were more significant in comparison with the control contralateral eyes, and were particularly evident in relation to the sulcus-fixated haptic in the case of 1-piece lenses. The majority of the eyes with 3-piece lenses showed signs of complicated surgery.
This study provides pathological correlation of complications that were clinically reported in the peer-reviewed literature in relation to sulcus fixation of one-piece hydrophobic acrylic IOLs. The eyes with 3-piece lenses generally exhibited evidences of complicated surgery; therefore all pathological findings in those cases may not be strictly attributed to the out-of-the-bag fixation.
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DOI: 10.1016/j.ophtha.2011.10.022
PubMed: 22424575
PubMed Central: 3343205
Affiliations:
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Moran Eye Center, University of Utah, Salt Lake City, UT, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>John A. Moran Eye Center, University of Utah, Salt Lake City, UT</wicri:regionArea><placeName><region type="state">Utah</region></placeName></affiliation></author><author><name sortKey="Jaber, Ryan" sort="Jaber, Ryan" uniqKey="Jaber R" first="Ryan" last="Jaber">Ryan Jaber</name><affiliation wicri:level="2"><nlm:aff id="A1">John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>John A. 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Moran Eye Center, University of Utah, Salt Lake City, UT, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>John A. 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Kirk</name><affiliation wicri:level="2"><nlm:aff id="A1">John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>John A. Moran Eye Center, University of Utah, Salt Lake City, UT</wicri:regionArea><placeName><region type="state">Utah</region></placeName></affiliation></author><author><name sortKey="Werner, Liliana" sort="Werner, Liliana" uniqKey="Werner L" first="Liliana" last="Werner">Liliana Werner</name><affiliation wicri:level="2"><nlm:aff id="A1">John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>John A. Moran Eye Center, University of Utah, Salt Lake City, UT</wicri:regionArea><placeName><region type="state">Utah</region></placeName></affiliation></author><author><name sortKey="Jaber, Ryan" sort="Jaber, Ryan" uniqKey="Jaber R" first="Ryan" last="Jaber">Ryan Jaber</name><affiliation wicri:level="2"><nlm:aff id="A1">John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>John A. Moran Eye Center, University of Utah, Salt Lake City, UT</wicri:regionArea><placeName><region type="state">Utah</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="A2">Dartmouth Medical School, Hanover, NH, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Dartmouth Medical School, Hanover, NH</wicri:regionArea><placeName><region type="state">New Hampshire</region></placeName></affiliation></author><author><name sortKey="Strenk, Susan" sort="Strenk, Susan" uniqKey="Strenk S" first="Susan" last="Strenk">Susan Strenk</name><affiliation wicri:level="2"><nlm:aff id="A3">MRI Research, Inc., Cleveland, OH, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>MRI Research, Inc., Cleveland, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Strenk, Lawrence" sort="Strenk, Lawrence" uniqKey="Strenk L" first="Lawrence" last="Strenk">Lawrence Strenk</name><affiliation wicri:level="2"><nlm:aff id="A3">MRI Research, Inc., Cleveland, OH, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>MRI Research, Inc., Cleveland, OH</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Mamalis, Nick" sort="Mamalis, Nick" uniqKey="Mamalis N" first="Nick" last="Mamalis">Nick Mamalis</name><affiliation wicri:level="2"><nlm:aff id="A1">John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>John A. Moran Eye Center, University of Utah, Salt Lake City, UT</wicri:regionArea><placeName><region type="state">Utah</region></placeName></affiliation></author></analytic><series><title level="j">Ophthalmology</title><idno type="ISSN">0161-6420</idno><idno type="eISSN">1549-4713</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">One-piece hydrophobic acrylic intraocular lenses (IOLs) are not indicated for sulcus fixation because of complications, such as uveitis-glaucoma-hyphema syndrome. Similar complications may also be observed with 3-piece lenses having a square optic edge on the anterior surface. The objective of this study was to provide pathological evidence of complications related to out-of-the-bag fixation of 1-piece or 3-piece hydrophobic acrylic IOLs with anterior and posterior square optic edges.</p></sec><sec id="S2"><title>Design</title><p id="P2">Comparative case series with pathology.</p></sec><sec id="S3"><title>Participants</title><p id="P3">559 pseudophakic cadaver eyes obtained from eye banks within the United States, implanted with different IOLs.</p></sec><sec id="S4"><title>Methods</title><p id="P4">Anterior segment scanning of whole eyes with a high-frequency ultrasound system, or with a high-resolution anterior segment magnetic resonance imaging, followed by gross examination. Selected eyes were processed for complete histopathological analysis; some of them were explanted before histopathology to allow for direct light microscopic evaluation of the lenses.</p></sec><sec id="S5"><title>Main Outcome Measures</title><p id="P5">Findings from imaging, gross, and histopathological evaluation that could be related to out-of-the-bag fixation of the lenses.</p></sec><sec id="S6"><title>Results</title><p id="P6">256 eyes were implanted with hydrophobic acrylic IOLs with anterior and posterior square optic edges; 18 of them exhibiting asymmetric or sulcus IOL fixation (six 1-piece, and twelve 3-piece IOLs) underwent complete histopathological evaluation and were compared to the contralateral eyes with symmetric in-the-bag IOL implantation. Pathological findings were composed of IOL decentration and tilt, pigmentary dispersion within the anterior segment and on the IOL surface, iris transillumination defects, iris changes including vacuolization/disruption/loss of the pigmented layer, iris thinning, and iris atrophy, as well as synechiae and loop erosion in the case of 3-piece lenses. Findings were more significant in comparison with the control contralateral eyes, and were particularly evident in relation to the sulcus-fixated haptic in the case of 1-piece lenses. The majority of the eyes with 3-piece lenses showed signs of complicated surgery.</p></sec><sec id="S7"><title>Conclusions</title><p id="P7">This study provides pathological correlation of complications that were clinically reported in the peer-reviewed literature in relation to sulcus fixation of one-piece hydrophobic acrylic IOLs. The eyes with 3-piece lenses generally exhibited evidences of complicated surgery; therefore all pathological findings in those cases may not be strictly attributed to the out-of-the-bag fixation.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">7802443</journal-id><journal-id journal-id-type="pubmed-jr-id">6266</journal-id><journal-id journal-id-type="nlm-ta">Ophthalmology</journal-id><journal-id journal-id-type="iso-abbrev">Ophthalmology</journal-id><journal-title-group><journal-title>Ophthalmology</journal-title></journal-title-group><issn pub-type="ppub">0161-6420</issn><issn pub-type="epub">1549-4713</issn></journal-meta><article-meta><article-id pub-id-type="pmid">22424575</article-id><article-id pub-id-type="pmc">3343205</article-id><article-id pub-id-type="doi">10.1016/j.ophtha.2011.10.022</article-id><article-id pub-id-type="manuscript">NIHMS333907</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Pathological assessment of complications with asymmetric or sulcus fixation of square-edged hydrophobic acrylic intraocular lenses</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kirk</surname><given-names>Kevin R.</given-names></name><degrees>BS</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Werner</surname><given-names>Liliana</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Jaber</surname><given-names>Ryan</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Strenk</surname><given-names>Susan</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Strenk</surname><given-names>Lawrence</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Mamalis</surname><given-names>Nick</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA</aff><aff id="A2"><label>2</label>Dartmouth Medical School, Hanover, NH, USA</aff><aff id="A3"><label>3</label>MRI Research, Inc., Cleveland, OH, USA</aff><author-notes><corresp id="FN1">Corresponding author: Liliana Werner, MD, PhD, John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Drive, Salt Lake City, UT 84132. Phone: 801 581 6586; FAX: 801 581 3357; <email>liliana.werner@hsc.utah.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>5</day><month>11</month><year>2011</year></pub-date><pub-date pub-type="epub"><day>15</day><month>3</month><year>2012</year></pub-date><pub-date pub-type="ppub"><month>5</month><year>2012</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>5</month><year>2013</year></pub-date><volume>119</volume><issue>5</issue><fpage>907</fpage><lpage>913</lpage><permissions><copyright-statement>© 2011 American Academy of Ophthalmology, Inc. Published by Elsevier Inc. All rights reserved.</copyright-statement><copyright-year>2011</copyright-year></permissions><abstract><sec id="S1"><title>Objective</title><p id="P1">One-piece hydrophobic acrylic intraocular lenses (IOLs) are not indicated for sulcus fixation because of complications, such as uveitis-glaucoma-hyphema syndrome. Similar complications may also be observed with 3-piece lenses having a square optic edge on the anterior surface. The objective of this study was to provide pathological evidence of complications related to out-of-the-bag fixation of 1-piece or 3-piece hydrophobic acrylic IOLs with anterior and posterior square optic edges.</p></sec><sec id="S2"><title>Design</title><p id="P2">Comparative case series with pathology.</p></sec><sec id="S3"><title>Participants</title><p id="P3">559 pseudophakic cadaver eyes obtained from eye banks within the United States, implanted with different IOLs.</p></sec><sec id="S4"><title>Methods</title><p id="P4">Anterior segment scanning of whole eyes with a high-frequency ultrasound system, or with a high-resolution anterior segment magnetic resonance imaging, followed by gross examination. Selected eyes were processed for complete histopathological analysis; some of them were explanted before histopathology to allow for direct light microscopic evaluation of the lenses.</p></sec><sec id="S5"><title>Main Outcome Measures</title><p id="P5">Findings from imaging, gross, and histopathological evaluation that could be related to out-of-the-bag fixation of the lenses.</p></sec><sec id="S6"><title>Results</title><p id="P6">256 eyes were implanted with hydrophobic acrylic IOLs with anterior and posterior square optic edges; 18 of them exhibiting asymmetric or sulcus IOL fixation (six 1-piece, and twelve 3-piece IOLs) underwent complete histopathological evaluation and were compared to the contralateral eyes with symmetric in-the-bag IOL implantation. Pathological findings were composed of IOL decentration and tilt, pigmentary dispersion within the anterior segment and on the IOL surface, iris transillumination defects, iris changes including vacuolization/disruption/loss of the pigmented layer, iris thinning, and iris atrophy, as well as synechiae and loop erosion in the case of 3-piece lenses. Findings were more significant in comparison with the control contralateral eyes, and were particularly evident in relation to the sulcus-fixated haptic in the case of 1-piece lenses. The majority of the eyes with 3-piece lenses showed signs of complicated surgery.</p></sec><sec id="S7"><title>Conclusions</title><p id="P7">This study provides pathological correlation of complications that were clinically reported in the peer-reviewed literature in relation to sulcus fixation of one-piece hydrophobic acrylic IOLs. The eyes with 3-piece lenses generally exhibited evidences of complicated surgery; therefore all pathological findings in those cases may not be strictly attributed to the out-of-the-bag fixation.</p></sec></abstract></article-meta></front></pmc><affiliations><list><country><li>États-Unis</li></country><region><li>New Hampshire</li><li>Ohio</li><li>Utah</li></region></list><tree><country name="États-Unis"><region name="Utah"><name sortKey="Kirk, Kevin R" sort="Kirk, Kevin R" uniqKey="Kirk K" first="Kevin R." last="Kirk">Kevin R. Kirk</name></region><name sortKey="Jaber, Ryan" sort="Jaber, Ryan" uniqKey="Jaber R" first="Ryan" last="Jaber">Ryan Jaber</name><name sortKey="Jaber, Ryan" sort="Jaber, Ryan" uniqKey="Jaber R" first="Ryan" last="Jaber">Ryan Jaber</name><name sortKey="Mamalis, Nick" sort="Mamalis, Nick" uniqKey="Mamalis N" first="Nick" last="Mamalis">Nick Mamalis</name><name sortKey="Strenk, Lawrence" sort="Strenk, Lawrence" uniqKey="Strenk L" first="Lawrence" last="Strenk">Lawrence Strenk</name><name sortKey="Strenk, Susan" sort="Strenk, Susan" uniqKey="Strenk S" first="Susan" last="Strenk">Susan Strenk</name><name sortKey="Werner, Liliana" sort="Werner, Liliana" uniqKey="Werner L" first="Liliana" last="Werner">Liliana Werner</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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