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Evaluation of neodymium:yttrium-aluminum-garnet capsulotomies in eyes implanted with AcrySof intraocular lenses

Identifieur interne : 001249 ( PascalFrancis/Corpus ); précédent : 001248; suivant : 001250

Evaluation of neodymium:yttrium-aluminum-garnet capsulotomies in eyes implanted with AcrySof intraocular lenses

Auteurs : Josef M. Schmidbauer ; Luis G. Vargas ; David J. Apple ; Marcela Escobar-Gomez ; Andrea Izak ; Stella N. Arthur ; Ariadne Golescu ; QUN PENG

Source :

RBID : Pascal:02-0467033

Descripteurs français

English descriptors

Abstract

Purpose: As of December 31, 2000, the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy rate for the Alcon AcrySof intraocular lens (IOL) as measured in our database was 3.3%. This was the lowest of any IOL model used in the United States. Only 12 of 361 cases required treatment. We analyzed possible surgical reasons that may have been responsible for the posterior capsule opacification (PCO) in this small group. Special attention was given to the three surgical factors that we had previously identified as being important for PCO reduction: (1) quality of cortical clean up, (2) type of haptic fixation, and (3) continuous curvilinear capsulorhexis (CCC) size and shape. Design: Comparative autopsy tissue analysis. Participants: Three hundred sixty-one human eyes obtained postmortem with Alcon AcrySof lOLs, accessioned between January 1995 and December 2000 from Lions Eye Banks. Methods: The eyes were evaluated by the Miyake-Apple posterior photographic technique. Main Outcome Measures: The area and intensity of Soemmering's ring and type of fixation were studied in 361 eyes. The size and shape of the CCC and relation of the CCC edge to the lOL's optic rim were analyzed in 168 eyes. Results: The amount of Soemmering's ring formation was significantly larger in the group of IOLs requiring Nd:YAG capsulotomy (Nd:YAG group). The not in-the-bag fixated lOLs required more Nd:YAG capsulotomies. Although the trend was clear, the number of specimens was not large enough to acquire statistical significance. The Nd:YAG group showed a highly significant difference compared with the No Nd:YAG group with regard to the amount of clock hours of the CCC edge on the optic rim's surface (P < 0.001). Mean CCC diameters were significantly larger in the Nd:YAG group (P < 0.05). Conclusions: The amount of Soemmering's ring correlates with the quality of cortical clean up. Cells within the Soemmering's ring are the direct precursors of PCO. This study confirms our previous laboratory studies and the clinical assumption that the incidence of PCO and thus the need for Nd:YAG capsulotomy is correlated with the cortical clean up. A second clinical assumption, that poor IOL fixation increases the risk of PCO, is also strongly suggested in this study. This study also verifies the relation of the CCC to PCO and the Nd:YAG laser, namely that a relatively small CCC without tears is best to prevent this complication. Use of a high-quality IOL combined with diligent attention to these three surgical factors should lower further the incidence of PCO.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

pA  
A01 01  1    @0 0161-6420
A02 01      @0 OPHTDG
A03   1    @0 Ophthalmology : (Rochester MN)
A05       @2 109
A06       @2 8
A08 01  1  ENG  @1 Evaluation of neodymium:yttrium-aluminum-garnet capsulotomies in eyes implanted with AcrySof intraocular lenses
A11 01  1    @1 SCHMIDBAUER (Josef M.)
A11 02  1    @1 VARGAS (Luis G.)
A11 03  1    @1 APPLE (David J.)
A11 04  1    @1 ESCOBAR-GOMEZ (Marcela)
A11 05  1    @1 IZAK (Andrea)
A11 06  1    @1 ARTHUR (Stella N.)
A11 07  1    @1 GOLESCU (Ariadne)
A11 08  1    @1 QUN PENG
A14 01      @1 Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina @2 Charleston, South Carolina @3 USA @Z 1 aut. @Z 2 aut. @Z 3 aut. @Z 4 aut. @Z 5 aut. @Z 6 aut. @Z 7 aut. @Z 8 aut.
A20       @1 1421-1426
A21       @1 2002
A23 01      @0 ENG
A43 01      @1 INIST @2 18914 @5 354000109006120060
A44       @0 0000 @1 © 2002 INIST-CNRS. All rights reserved.
A45       @0 37 ref.
A47 01  1    @0 02-0467033
A60       @1 P
A61       @0 A
A64 01  1    @0 Ophthalmology : (Rochester, MN)
A66 01      @0 USA
C01 01    ENG  @0 Purpose: As of December 31, 2000, the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy rate for the Alcon AcrySof intraocular lens (IOL) as measured in our database was 3.3%. This was the lowest of any IOL model used in the United States. Only 12 of 361 cases required treatment. We analyzed possible surgical reasons that may have been responsible for the posterior capsule opacification (PCO) in this small group. Special attention was given to the three surgical factors that we had previously identified as being important for PCO reduction: (1) quality of cortical clean up, (2) type of haptic fixation, and (3) continuous curvilinear capsulorhexis (CCC) size and shape. Design: Comparative autopsy tissue analysis. Participants: Three hundred sixty-one human eyes obtained postmortem with Alcon AcrySof lOLs, accessioned between January 1995 and December 2000 from Lions Eye Banks. Methods: The eyes were evaluated by the Miyake-Apple posterior photographic technique. Main Outcome Measures: The area and intensity of Soemmering's ring and type of fixation were studied in 361 eyes. The size and shape of the CCC and relation of the CCC edge to the lOL's optic rim were analyzed in 168 eyes. Results: The amount of Soemmering's ring formation was significantly larger in the group of IOLs requiring Nd:YAG capsulotomy (Nd:YAG group). The not in-the-bag fixated lOLs required more Nd:YAG capsulotomies. Although the trend was clear, the number of specimens was not large enough to acquire statistical significance. The Nd:YAG group showed a highly significant difference compared with the No Nd:YAG group with regard to the amount of clock hours of the CCC edge on the optic rim's surface (P < 0.001). Mean CCC diameters were significantly larger in the Nd:YAG group (P < 0.05). Conclusions: The amount of Soemmering's ring correlates with the quality of cortical clean up. Cells within the Soemmering's ring are the direct precursors of PCO. This study confirms our previous laboratory studies and the clinical assumption that the incidence of PCO and thus the need for Nd:YAG capsulotomy is correlated with the cortical clean up. A second clinical assumption, that poor IOL fixation increases the risk of PCO, is also strongly suggested in this study. This study also verifies the relation of the CCC to PCO and the Nd:YAG laser, namely that a relatively small CCC without tears is best to prevent this complication. Use of a high-quality IOL combined with diligent attention to these three surgical factors should lower further the incidence of PCO.
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C03 01  X  ENG  @0 Laser @5 01
C03 01  X  SPA  @0 Laser @5 01
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C03 05  X  ENG  @0 Intraocular lens @5 05
C03 05  X  SPA  @0 Lente intraocular @5 05
C03 06  X  FRE  @0 Implanté @5 06
C03 06  X  ENG  @0 Implanted @5 06
C03 06  X  SPA  @0 Implantado @5 06
C03 07  X  FRE  @0 Opacification @5 07
C03 07  X  ENG  @0 Opacification @5 07
C03 07  X  SPA  @0 Opacificación @5 07
C03 08  X  FRE  @0 Capsule @5 08
C03 08  X  ENG  @0 Capsule @5 08
C03 08  X  SPA  @0 Cápsula @5 08
C03 09  X  FRE  @0 Postérieur @5 09
C03 09  X  ENG  @0 Posterior @5 09
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C03 11  X  SPA  @0 Técnica @5 11
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C07 01  X  SPA  @0 Cirugía @5 45
N21       @1 273
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Format Inist (serveur)

NO : PASCAL 02-0467033 INIST
ET : Evaluation of neodymium:yttrium-aluminum-garnet capsulotomies in eyes implanted with AcrySof intraocular lenses
AU : SCHMIDBAUER (Josef M.); VARGAS (Luis G.); APPLE (David J.); ESCOBAR-GOMEZ (Marcela); IZAK (Andrea); ARTHUR (Stella N.); GOLESCU (Ariadne); QUN PENG
AF : Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina/Charleston, South Carolina/Etats-Unis (1 aut., 2 aut., 3 aut., 4 aut., 5 aut., 6 aut., 7 aut., 8 aut.)
DT : Publication en série; Niveau analytique
SO : Ophthalmology : (Rochester, MN); ISSN 0161-6420; Coden OPHTDG; Etats-Unis; Da. 2002; Vol. 109; No. 8; Pp. 1421-1426; Bibl. 37 ref.
LA : Anglais
EA : Purpose: As of December 31, 2000, the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy rate for the Alcon AcrySof intraocular lens (IOL) as measured in our database was 3.3%. This was the lowest of any IOL model used in the United States. Only 12 of 361 cases required treatment. We analyzed possible surgical reasons that may have been responsible for the posterior capsule opacification (PCO) in this small group. Special attention was given to the three surgical factors that we had previously identified as being important for PCO reduction: (1) quality of cortical clean up, (2) type of haptic fixation, and (3) continuous curvilinear capsulorhexis (CCC) size and shape. Design: Comparative autopsy tissue analysis. Participants: Three hundred sixty-one human eyes obtained postmortem with Alcon AcrySof lOLs, accessioned between January 1995 and December 2000 from Lions Eye Banks. Methods: The eyes were evaluated by the Miyake-Apple posterior photographic technique. Main Outcome Measures: The area and intensity of Soemmering's ring and type of fixation were studied in 361 eyes. The size and shape of the CCC and relation of the CCC edge to the lOL's optic rim were analyzed in 168 eyes. Results: The amount of Soemmering's ring formation was significantly larger in the group of IOLs requiring Nd:YAG capsulotomy (Nd:YAG group). The not in-the-bag fixated lOLs required more Nd:YAG capsulotomies. Although the trend was clear, the number of specimens was not large enough to acquire statistical significance. The Nd:YAG group showed a highly significant difference compared with the No Nd:YAG group with regard to the amount of clock hours of the CCC edge on the optic rim's surface (P < 0.001). Mean CCC diameters were significantly larger in the Nd:YAG group (P < 0.05). Conclusions: The amount of Soemmering's ring correlates with the quality of cortical clean up. Cells within the Soemmering's ring are the direct precursors of PCO. This study confirms our previous laboratory studies and the clinical assumption that the incidence of PCO and thus the need for Nd:YAG capsulotomy is correlated with the cortical clean up. A second clinical assumption, that poor IOL fixation increases the risk of PCO, is also strongly suggested in this study. This study also verifies the relation of the CCC to PCO and the Nd:YAG laser, namely that a relatively small CCC without tears is best to prevent this complication. Use of a high-quality IOL combined with diligent attention to these three surgical factors should lower further the incidence of PCO.
CC : 002B25B
FD : Laser; Néodyme; Yttrium; Capsulotomie; Lentille intraoculaire; Implanté; Opacification; Capsule; Postérieur; Traitement; Technique; Autopsie; Oeil; Homme
FG : Chirurgie
ED : Laser; Neodymium; Yttrium; Capsulotomy; Intraocular lens; Implanted; Opacification; Capsule; Posterior; Treatment; Technique; Autopsy; Eye; Human
EG : Surgery
SD : Laser; Neodimio; Ytrio; Lente intraocular; Implantado; Opacificación; Cápsula; Posterior; Tratamiento; Técnica; Autopsia; Ojo; Hombre
LO : INIST-18914.354000109006120060
ID : 02-0467033

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Pascal:02-0467033

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<title level="j" type="main">Ophthalmology : (Rochester, MN)</title>
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<term>Autopsy</term>
<term>Capsule</term>
<term>Capsulotomy</term>
<term>Eye</term>
<term>Human</term>
<term>Implanted</term>
<term>Intraocular lens</term>
<term>Laser</term>
<term>Neodymium</term>
<term>Opacification</term>
<term>Posterior</term>
<term>Technique</term>
<term>Treatment</term>
<term>Yttrium</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Laser</term>
<term>Néodyme</term>
<term>Yttrium</term>
<term>Capsulotomie</term>
<term>Lentille intraoculaire</term>
<term>Implanté</term>
<term>Opacification</term>
<term>Capsule</term>
<term>Postérieur</term>
<term>Traitement</term>
<term>Technique</term>
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<div type="abstract" xml:lang="en">Purpose: As of December 31, 2000, the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy rate for the Alcon AcrySof intraocular lens (IOL) as measured in our database was 3.3%. This was the lowest of any IOL model used in the United States. Only 12 of 361 cases required treatment. We analyzed possible surgical reasons that may have been responsible for the posterior capsule opacification (PCO) in this small group. Special attention was given to the three surgical factors that we had previously identified as being important for PCO reduction: (1) quality of cortical clean up, (2) type of haptic fixation, and (3) continuous curvilinear capsulorhexis (CCC) size and shape. Design: Comparative autopsy tissue analysis. Participants: Three hundred sixty-one human eyes obtained postmortem with Alcon AcrySof lOLs, accessioned between January 1995 and December 2000 from Lions Eye Banks. Methods: The eyes were evaluated by the Miyake-Apple posterior photographic technique. Main Outcome Measures: The area and intensity of Soemmering's ring and type of fixation were studied in 361 eyes. The size and shape of the CCC and relation of the CCC edge to the lOL's optic rim were analyzed in 168 eyes. Results: The amount of Soemmering's ring formation was significantly larger in the group of IOLs requiring Nd:YAG capsulotomy (Nd:YAG group). The not in-the-bag fixated lOLs required more Nd:YAG capsulotomies. Although the trend was clear, the number of specimens was not large enough to acquire statistical significance. The Nd:YAG group showed a highly significant difference compared with the No Nd:YAG group with regard to the amount of clock hours of the CCC edge on the optic rim's surface (P < 0.001). Mean CCC diameters were significantly larger in the Nd:YAG group (P < 0.05). Conclusions: The amount of Soemmering's ring correlates with the quality of cortical clean up. Cells within the Soemmering's ring are the direct precursors of PCO. This study confirms our previous laboratory studies and the clinical assumption that the incidence of PCO and thus the need for Nd:YAG capsulotomy is correlated with the cortical clean up. A second clinical assumption, that poor IOL fixation increases the risk of PCO, is also strongly suggested in this study. This study also verifies the relation of the CCC to PCO and the Nd:YAG laser, namely that a relatively small CCC without tears is best to prevent this complication. Use of a high-quality IOL combined with diligent attention to these three surgical factors should lower further the incidence of PCO.</div>
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<s0>Purpose: As of December 31, 2000, the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy rate for the Alcon AcrySof intraocular lens (IOL) as measured in our database was 3.3%. This was the lowest of any IOL model used in the United States. Only 12 of 361 cases required treatment. We analyzed possible surgical reasons that may have been responsible for the posterior capsule opacification (PCO) in this small group. Special attention was given to the three surgical factors that we had previously identified as being important for PCO reduction: (1) quality of cortical clean up, (2) type of haptic fixation, and (3) continuous curvilinear capsulorhexis (CCC) size and shape. Design: Comparative autopsy tissue analysis. Participants: Three hundred sixty-one human eyes obtained postmortem with Alcon AcrySof lOLs, accessioned between January 1995 and December 2000 from Lions Eye Banks. Methods: The eyes were evaluated by the Miyake-Apple posterior photographic technique. Main Outcome Measures: The area and intensity of Soemmering's ring and type of fixation were studied in 361 eyes. The size and shape of the CCC and relation of the CCC edge to the lOL's optic rim were analyzed in 168 eyes. Results: The amount of Soemmering's ring formation was significantly larger in the group of IOLs requiring Nd:YAG capsulotomy (Nd:YAG group). The not in-the-bag fixated lOLs required more Nd:YAG capsulotomies. Although the trend was clear, the number of specimens was not large enough to acquire statistical significance. The Nd:YAG group showed a highly significant difference compared with the No Nd:YAG group with regard to the amount of clock hours of the CCC edge on the optic rim's surface (P < 0.001). Mean CCC diameters were significantly larger in the Nd:YAG group (P < 0.05). Conclusions: The amount of Soemmering's ring correlates with the quality of cortical clean up. Cells within the Soemmering's ring are the direct precursors of PCO. This study confirms our previous laboratory studies and the clinical assumption that the incidence of PCO and thus the need for Nd:YAG capsulotomy is correlated with the cortical clean up. A second clinical assumption, that poor IOL fixation increases the risk of PCO, is also strongly suggested in this study. This study also verifies the relation of the CCC to PCO and the Nd:YAG laser, namely that a relatively small CCC without tears is best to prevent this complication. Use of a high-quality IOL combined with diligent attention to these three surgical factors should lower further the incidence of PCO.</s0>
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<NO>PASCAL 02-0467033 INIST</NO>
<ET>Evaluation of neodymium:yttrium-aluminum-garnet capsulotomies in eyes implanted with AcrySof intraocular lenses</ET>
<AU>SCHMIDBAUER (Josef M.); VARGAS (Luis G.); APPLE (David J.); ESCOBAR-GOMEZ (Marcela); IZAK (Andrea); ARTHUR (Stella N.); GOLESCU (Ariadne); QUN PENG</AU>
<AF>Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina/Charleston, South Carolina/Etats-Unis (1 aut., 2 aut., 3 aut., 4 aut., 5 aut., 6 aut., 7 aut., 8 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Ophthalmology : (Rochester, MN); ISSN 0161-6420; Coden OPHTDG; Etats-Unis; Da. 2002; Vol. 109; No. 8; Pp. 1421-1426; Bibl. 37 ref.</SO>
<LA>Anglais</LA>
<EA>Purpose: As of December 31, 2000, the neodymium:yttrium-aluminum-garnet (Nd:YAG) laser posterior capsulotomy rate for the Alcon AcrySof intraocular lens (IOL) as measured in our database was 3.3%. This was the lowest of any IOL model used in the United States. Only 12 of 361 cases required treatment. We analyzed possible surgical reasons that may have been responsible for the posterior capsule opacification (PCO) in this small group. Special attention was given to the three surgical factors that we had previously identified as being important for PCO reduction: (1) quality of cortical clean up, (2) type of haptic fixation, and (3) continuous curvilinear capsulorhexis (CCC) size and shape. Design: Comparative autopsy tissue analysis. Participants: Three hundred sixty-one human eyes obtained postmortem with Alcon AcrySof lOLs, accessioned between January 1995 and December 2000 from Lions Eye Banks. Methods: The eyes were evaluated by the Miyake-Apple posterior photographic technique. Main Outcome Measures: The area and intensity of Soemmering's ring and type of fixation were studied in 361 eyes. The size and shape of the CCC and relation of the CCC edge to the lOL's optic rim were analyzed in 168 eyes. Results: The amount of Soemmering's ring formation was significantly larger in the group of IOLs requiring Nd:YAG capsulotomy (Nd:YAG group). The not in-the-bag fixated lOLs required more Nd:YAG capsulotomies. Although the trend was clear, the number of specimens was not large enough to acquire statistical significance. The Nd:YAG group showed a highly significant difference compared with the No Nd:YAG group with regard to the amount of clock hours of the CCC edge on the optic rim's surface (P < 0.001). Mean CCC diameters were significantly larger in the Nd:YAG group (P < 0.05). Conclusions: The amount of Soemmering's ring correlates with the quality of cortical clean up. Cells within the Soemmering's ring are the direct precursors of PCO. This study confirms our previous laboratory studies and the clinical assumption that the incidence of PCO and thus the need for Nd:YAG capsulotomy is correlated with the cortical clean up. A second clinical assumption, that poor IOL fixation increases the risk of PCO, is also strongly suggested in this study. This study also verifies the relation of the CCC to PCO and the Nd:YAG laser, namely that a relatively small CCC without tears is best to prevent this complication. Use of a high-quality IOL combined with diligent attention to these three surgical factors should lower further the incidence of PCO.</EA>
<CC>002B25B</CC>
<FD>Laser; Néodyme; Yttrium; Capsulotomie; Lentille intraoculaire; Implanté; Opacification; Capsule; Postérieur; Traitement; Technique; Autopsie; Oeil; Homme</FD>
<FG>Chirurgie</FG>
<ED>Laser; Neodymium; Yttrium; Capsulotomy; Intraocular lens; Implanted; Opacification; Capsule; Posterior; Treatment; Technique; Autopsy; Eye; Human</ED>
<EG>Surgery</EG>
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