Capsulorhexis phimosis with anterior flexing of an accommodating IOL: case report and histopathological analyses.
Identifieur interne : 002B78 ( Ncbi/Checkpoint ); précédent : 002B77; suivant : 002B79Capsulorhexis phimosis with anterior flexing of an accommodating IOL: case report and histopathological analyses.
Auteurs : Rachel H. Epstein [Allemagne] ; Erica T. Liu [Allemagne] ; Liliana Werner [Allemagne] ; Thomas Kohnen [Allemagne] ; Oliver K. Kaproth [Allemagne] ; Nick Mamalis [Allemagne]Source :
- Journal of cataract and refractive surgery [ 1873-4502 ] ; 2014.
English descriptors
- KwdEn :
- Aged, Anterior Capsule of the Lens (pathology), Artificial Lens Implant Migration (etiology), Artificial Lens Implant Migration (surgery), Capsulorhexis, Device Removal, Epithelial Cells (pathology), Female, Fibrosis, Humans, Lens Implantation, Intraocular, Lenses, Intraocular, Metaplasia, Phacoemulsification, Prosthesis Design, Prosthesis Failure.
- MESH :
- etiology : Artificial Lens Implant Migration.
- pathology : Anterior Capsule of the Lens, Epithelial Cells.
- surgery : Artificial Lens Implant Migration.
- Aged, Capsulorhexis, Device Removal, Female, Fibrosis, Humans, Lens Implantation, Intraocular, Lenses, Intraocular, Metaplasia, Phacoemulsification, Prosthesis Design, Prosthesis Failure.
Abstract
We describe the case of a patient who had cataract surgery with implantation of an accommodating hydrophilic acrylic intraocular lens (IOL) that exhibited capsulorhexis phimosis and in-the-bag IOL luxation leading to explantation of the IOL-capsular bag complex 10 years after implantation. Constriction of the capsular bag secondary to fibrosis caused significant anterior flexing of the haptic elements of the IOL. Histopathological analysis revealed dense anterior subcapsular fibrosis and fibrous metaplasia of the anterior lens epithelial cells. No signs suggestive of pseudoexfoliation were found. This case raises concerns related to the continuously evolving indications for implantation of accommodating and other highly flexible IOLs (eg, microincision IOLs), particularly in patients with no clear predisposition to zonular weakness and, accordingly, excessive capsular bag contraction.
DOI: 10.1016/j.jcrs.2013.10.027
PubMed: 24355727
Affiliations:
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<author><name sortKey="Epstein, Rachel H" sort="Epstein, Rachel H" uniqKey="Epstein R" first="Rachel H" last="Epstein">Rachel H. Epstein</name>
<affiliation wicri:level="1"><nlm:affiliation>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt</wicri:regionArea>
<wicri:noRegion>Frankfurt</wicri:noRegion>
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<author><name sortKey="Liu, Erica T" sort="Liu, Erica T" uniqKey="Liu E" first="Erica T" last="Liu">Erica T. Liu</name>
<affiliation wicri:level="1"><nlm:affiliation>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt</wicri:regionArea>
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<affiliation wicri:level="1"><nlm:affiliation>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt</wicri:regionArea>
<wicri:noRegion>Frankfurt</wicri:noRegion>
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<affiliation wicri:level="1"><nlm:affiliation>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt</wicri:regionArea>
<wicri:noRegion>Frankfurt</wicri:noRegion>
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<author><name sortKey="Mamalis, Nick" sort="Mamalis, Nick" uniqKey="Mamalis N" first="Nick" last="Mamalis">Nick Mamalis</name>
<affiliation wicri:level="1"><nlm:affiliation>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt</wicri:regionArea>
<wicri:noRegion>Frankfurt</wicri:noRegion>
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<affiliation wicri:level="1"><nlm:affiliation>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt</wicri:regionArea>
<wicri:noRegion>Frankfurt</wicri:noRegion>
<wicri:noRegion>Frankfurt</wicri:noRegion>
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<author><name sortKey="Liu, Erica T" sort="Liu, Erica T" uniqKey="Liu E" first="Erica T" last="Liu">Erica T. Liu</name>
<affiliation wicri:level="1"><nlm:affiliation>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt</wicri:regionArea>
<wicri:noRegion>Frankfurt</wicri:noRegion>
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<author><name sortKey="Werner, Liliana" sort="Werner, Liliana" uniqKey="Werner L" first="Liliana" last="Werner">Liliana Werner</name>
<affiliation wicri:level="1"><nlm:affiliation>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt, Germany. Electronic address: liliana.werner@hsc.utah.edu.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt</wicri:regionArea>
<wicri:noRegion>Frankfurt</wicri:noRegion>
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<author><name sortKey="Kohnen, Thomas" sort="Kohnen, Thomas" uniqKey="Kohnen T" first="Thomas" last="Kohnen">Thomas Kohnen</name>
<affiliation wicri:level="1"><nlm:affiliation>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt</wicri:regionArea>
<wicri:noRegion>Frankfurt</wicri:noRegion>
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<affiliation wicri:level="1"><nlm:affiliation>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt</wicri:regionArea>
<wicri:noRegion>Frankfurt</wicri:noRegion>
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<author><name sortKey="Mamalis, Nick" sort="Mamalis, Nick" uniqKey="Mamalis N" first="Nick" last="Mamalis">Nick Mamalis</name>
<affiliation wicri:level="1"><nlm:affiliation>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt, Germany.</nlm:affiliation>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea>From the John A. Moran Eye Center (Epstein, Liu, Werner, Mamalis), University of Utah, Salt Lake City, Utah, USA; the Department of Ophthalmology (Kohnen, Kaproth), Goethe-University, Frankfurt</wicri:regionArea>
<wicri:noRegion>Frankfurt</wicri:noRegion>
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<wicri:noRegion>Frankfurt</wicri:noRegion>
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<series><title level="j">Journal of cataract and refractive surgery</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Anterior Capsule of the Lens (pathology)</term>
<term>Artificial Lens Implant Migration (etiology)</term>
<term>Artificial Lens Implant Migration (surgery)</term>
<term>Capsulorhexis</term>
<term>Device Removal</term>
<term>Epithelial Cells (pathology)</term>
<term>Female</term>
<term>Fibrosis</term>
<term>Humans</term>
<term>Lens Implantation, Intraocular</term>
<term>Lenses, Intraocular</term>
<term>Metaplasia</term>
<term>Phacoemulsification</term>
<term>Prosthesis Design</term>
<term>Prosthesis Failure</term>
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<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Artificial Lens Implant Migration</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Anterior Capsule of the Lens</term>
<term>Epithelial Cells</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Artificial Lens Implant Migration</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Capsulorhexis</term>
<term>Device Removal</term>
<term>Female</term>
<term>Fibrosis</term>
<term>Humans</term>
<term>Lens Implantation, Intraocular</term>
<term>Lenses, Intraocular</term>
<term>Metaplasia</term>
<term>Phacoemulsification</term>
<term>Prosthesis Design</term>
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<front><div type="abstract" xml:lang="en">We describe the case of a patient who had cataract surgery with implantation of an accommodating hydrophilic acrylic intraocular lens (IOL) that exhibited capsulorhexis phimosis and in-the-bag IOL luxation leading to explantation of the IOL-capsular bag complex 10 years after implantation. Constriction of the capsular bag secondary to fibrosis caused significant anterior flexing of the haptic elements of the IOL. Histopathological analysis revealed dense anterior subcapsular fibrosis and fibrous metaplasia of the anterior lens epithelial cells. No signs suggestive of pseudoexfoliation were found. This case raises concerns related to the continuously evolving indications for implantation of accommodating and other highly flexible IOLs (eg, microincision IOLs), particularly in patients with no clear predisposition to zonular weakness and, accordingly, excessive capsular bag contraction.</div>
</front>
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<affiliations><list><country><li>Allemagne</li>
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<tree><country name="Allemagne"><noRegion><name sortKey="Epstein, Rachel H" sort="Epstein, Rachel H" uniqKey="Epstein R" first="Rachel H" last="Epstein">Rachel H. Epstein</name>
</noRegion>
<name sortKey="Kaproth, Oliver K" sort="Kaproth, Oliver K" uniqKey="Kaproth O" first="Oliver K" last="Kaproth">Oliver K. Kaproth</name>
<name sortKey="Kohnen, Thomas" sort="Kohnen, Thomas" uniqKey="Kohnen T" first="Thomas" last="Kohnen">Thomas Kohnen</name>
<name sortKey="Liu, Erica T" sort="Liu, Erica T" uniqKey="Liu E" first="Erica T" last="Liu">Erica T. Liu</name>
<name sortKey="Mamalis, Nick" sort="Mamalis, Nick" uniqKey="Mamalis N" first="Nick" last="Mamalis">Nick Mamalis</name>
<name sortKey="Werner, Liliana" sort="Werner, Liliana" uniqKey="Werner L" first="Liliana" last="Werner">Liliana Werner</name>
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