Surgical prevention of posterior capsule opacification
Identifieur interne : 002531 ( Istex/Curation ); précédent : 002530; suivant : 002532Surgical prevention of posterior capsule opacification
Auteurs : Qun Peng [États-Unis] ; Nithi Visessook [États-Unis] ; David J. Apple [États-Unis] ; Suresh K. Pandey [États-Unis] ; Liliana Werner [États-Unis] ; Marcela Escobar-Gomez [États-Unis] ; Robert Schoderbek [États-Unis] ; Kerry D. Solomon [États-Unis] ; Alfred Guindi [États-Unis]Source :
- Journal of Cataract & Refractive Surgery [ 0886-3350 ] ; 1999.
Abstract
Purpose To emphasize an important aspect of preventing posterior capsule opacification (PCO), the barrier effect established by the optic of a posterior chamber intraocular lens (PC IOL), and present a new classification regarding capsular bag status after extracapsular cataract extraction, including phacoemulsification.Setting Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA.Methods This analysis included 150 consecutive eyes obtained postmortem with United States-manufactured PC IOLs including (1) poly(methyl methacrylate), (2) silicone, and (3) hydrophobic acrylic designs that were accessioned in the Center from September 1995 to January 1, 1998. Gross photographs from behind (Miyake–Apple views) were taken and serial histologic sections prepared.Results Microscopic analysis of the 150 eyes showed that the morphologic appearance of the capsular bag could be grouped into 2 categories: (1) those with little or no evidence of retained cortical material and cells, and (2) those with retained cortical material and cells in which a Soemmering’s ring formed. With the latter, when a distinct barricade to cellular migration created by the IOL optic was noted, 2 discrete configurations occurred, depending on the different geometries of the optic components. With a classic biconvex optic with a curved and tapered edge, in many instances some ingrowth of cells proceeded posteriorly around the edge of the IOL optic in the direction of the central axis. With a lens optic that had a squared, truncated, and relatively thick edge, there was often abrupt termination of cells at the peripheral edge of the optic. The posterior capsule subtending the entire optic zone was therefore relatively or totally cell free.Conclusions The barrier effect of the IOL optic appears to be of critical importance in retarding ingrowth of cells, functioning as a second line of defense when cortical cleanup is incomplete. Analysis of PC IOLs obtained postmortem showed that a square, truncated optic edge seemed to provide the maximum impediment to cell growth behind the IOL optic.
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DOI: 10.1016/S0886-3350(99)00352-1
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Surgical prevention of posterior capsule opacification</title><author><name sortKey="Peng, Qun" sort="Peng, Qun" uniqKey="Peng Q" first="Qun" last="Peng">Qun Peng</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Visessook, Nithi" sort="Visessook, Nithi" uniqKey="Visessook N" first="Nithi" last="Visessook">Nithi Visessook</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Apple, David J" sort="Apple, David J" uniqKey="Apple D" first="David J" last="Apple">David J. Apple</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Pandey, Suresh K" sort="Pandey, Suresh K" uniqKey="Pandey S" first="Suresh K" last="Pandey">Suresh K. Pandey</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Werner, Liliana" sort="Werner, Liliana" uniqKey="Werner L" first="Liliana" last="Werner">Liliana Werner</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Escobar Gomez, Marcela" sort="Escobar Gomez, Marcela" uniqKey="Escobar Gomez M" first="Marcela" last="Escobar-Gomez">Marcela Escobar-Gomez</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Schoderbek, Robert" sort="Schoderbek, Robert" uniqKey="Schoderbek R" first="Robert" last="Schoderbek">Robert Schoderbek</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Solomon, Kerry D" sort="Solomon, Kerry D" uniqKey="Solomon K" first="Kerry D" last="Solomon">Kerry D. Solomon</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Guindi, Alfred" sort="Guindi, Alfred" uniqKey="Guindi A" first="Alfred" last="Guindi">Alfred Guindi</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:453A1C3A116D03AA81E0233483D823E7178257EB</idno><date when="2000" year="2000">2000</date><idno type="doi">10.1016/S0886-3350(99)00352-1</idno><idno type="url">https://api.istex.fr/document/453A1C3A116D03AA81E0233483D823E7178257EB/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">002531</idno><idno type="wicri:Area/Istex/Curation">002531</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Surgical prevention of posterior capsule opacification</title><author><name sortKey="Peng, Qun" sort="Peng, Qun" uniqKey="Peng Q" first="Qun" last="Peng">Qun Peng</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Visessook, Nithi" sort="Visessook, Nithi" uniqKey="Visessook N" first="Nithi" last="Visessook">Nithi Visessook</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Apple, David J" sort="Apple, David J" uniqKey="Apple D" first="David J" last="Apple">David J. Apple</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Pandey, Suresh K" sort="Pandey, Suresh K" uniqKey="Pandey S" first="Suresh K" last="Pandey">Suresh K. Pandey</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Werner, Liliana" sort="Werner, Liliana" uniqKey="Werner L" first="Liliana" last="Werner">Liliana Werner</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Escobar Gomez, Marcela" sort="Escobar Gomez, Marcela" uniqKey="Escobar Gomez M" first="Marcela" last="Escobar-Gomez">Marcela Escobar-Gomez</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Schoderbek, Robert" sort="Schoderbek, Robert" uniqKey="Schoderbek R" first="Robert" last="Schoderbek">Robert Schoderbek</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Solomon, Kerry D" sort="Solomon, Kerry D" uniqKey="Solomon K" first="Kerry D" last="Solomon">Kerry D. Solomon</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author><author><name sortKey="Guindi, Alfred" sort="Guindi, Alfred" uniqKey="Guindi A" first="Alfred" last="Guindi">Alfred Guindi</name><affiliation wicri:level="1"><mods:affiliation>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>the Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Cataract & Refractive Surgery</title><title level="j" type="abbrev">JCRS</title><idno type="ISSN">0886-3350</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1999">1999</date><biblScope unit="volume">26</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="198">198</biblScope><biblScope unit="page" to="213">213</biblScope></imprint><idno type="ISSN">0886-3350</idno></series><idno type="istex">453A1C3A116D03AA81E0233483D823E7178257EB</idno><idno type="DOI">10.1016/S0886-3350(99)00352-1</idno><idno type="PII">S0886-3350(99)00352-1</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0886-3350</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Purpose To emphasize an important aspect of preventing posterior capsule opacification (PCO), the barrier effect established by the optic of a posterior chamber intraocular lens (PC IOL), and present a new classification regarding capsular bag status after extracapsular cataract extraction, including phacoemulsification.Setting Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA.Methods This analysis included 150 consecutive eyes obtained postmortem with United States-manufactured PC IOLs including (1) poly(methyl methacrylate), (2) silicone, and (3) hydrophobic acrylic designs that were accessioned in the Center from September 1995 to January 1, 1998. Gross photographs from behind (Miyake–Apple views) were taken and serial histologic sections prepared.Results Microscopic analysis of the 150 eyes showed that the morphologic appearance of the capsular bag could be grouped into 2 categories: (1) those with little or no evidence of retained cortical material and cells, and (2) those with retained cortical material and cells in which a Soemmering’s ring formed. With the latter, when a distinct barricade to cellular migration created by the IOL optic was noted, 2 discrete configurations occurred, depending on the different geometries of the optic components. With a classic biconvex optic with a curved and tapered edge, in many instances some ingrowth of cells proceeded posteriorly around the edge of the IOL optic in the direction of the central axis. With a lens optic that had a squared, truncated, and relatively thick edge, there was often abrupt termination of cells at the peripheral edge of the optic. The posterior capsule subtending the entire optic zone was therefore relatively or totally cell free.Conclusions The barrier effect of the IOL optic appears to be of critical importance in retarding ingrowth of cells, functioning as a second line of defense when cortical cleanup is incomplete. Analysis of PC IOLs obtained postmortem showed that a square, truncated optic edge seemed to provide the maximum impediment to cell growth behind the IOL optic.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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