1
|
Son HS, Lee JM, Khoramnia R, Choi CY. Comparative Surface Imaging Study of Multifocal Diffractive Intraocular Lenses. Klin Monbl Augenheilkd 2021; 239:982-990. [PMID: 33607689 DOI: 10.1055/a-1328-2550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To analyse and compare the surface topography and roughness of three different types of diffractive multifocal IOLs. METHODS Using scanning electron microscope (SEM, Inspect F, 5.0 KV, maximum magnification up to 20,000) and atomic force microscope (AFM, Park Systems, XE-100, non-contact, area profile comparison, 10 × 10 µm, 40 × 40 µm), the surface quality of the following diffractive IOLs was studied: the AcrySof IQ PanOptix (Alcon, USA), the AT LARA 829MP (Carl Zeiss Meditec, Germany), and Tecnis Symfony (Johnson&Johnson Vision, USA). The measurements were made over three representative areas (central non-diffractive optic, central diffractive optic, and diffractive step) of each IOL. Roughness profile in terms of mean arithmetic roughness (Ra) and root-mean-squared roughness (Rq) values were obtained and compared statistically. RESULTS In SEM examination, all IOLs showed a smooth optical surface without any irregularities at low magnification. At higher magnification, Tecnis Symfony showed unique highly regular, concentric, and lineate structures in the diffractive optic area which could not be seen in the other studied diffractive IOLs. The differences in the measured Ra and Rq values of the Tecnis Symfony were statistically significant compared to the other models (p < 0.05). CONCLUSION Various different topographical traits were observed in three diffractive multifocal IOLs. The Ra values of all studied IOLs were within an acceptable range. Tecnis Symfony showed statistically significant higher surface Ra values at both central diffractive optic and diffractive step areas. Furthermore, compared to its counterparts, Tecnis Symfony demonstrated highly ordered, concentric pattern in its diffractive surfaces.
Collapse
Affiliation(s)
- Hyeck Soo Son
- David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
| | - Jung Min Lee
- Department of Ophthalmology, Kangbuk Samsung Hospital, Jongno-gu, Republic of Korea
| | - Ramin Khoramnia
- David J Apple International Laboratory for Ocular Pathology, Univ.-Augenklinik Heidelberg, Deutschland
| | - Chul Young Choi
- Department of Ophthalmology, Kangbuk Samsung Hospital, Jongno-gu, Republic of Korea
| |
Collapse
|
2
|
Advances in the Study of Lens Refilling. J Ophthalmol 2020; 2020:8956275. [PMID: 32908687 PMCID: PMC7471792 DOI: 10.1155/2020/8956275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/22/2020] [Accepted: 07/29/2020] [Indexed: 12/03/2022] Open
Abstract
The ultimate goal of cataract surgery is to restore the accommodation while restoring distance visual acuity. Different kinds of accommodative intraocular lens (IOLs) and surgical techniques have been suggested to apply during the surgery, but they showed poor postoperative accommodation. It is possible to achieve this goal by refilling the lens with an injectable polymer. We present a summary of the existing materials, methods, results, and some obstacles in clinical application that remain of lens refilling for restoration of accommodation. Two main problems have restricted the clinical application of this technique. One was the formation of postoperative secondary capsule opacification and the other was the different accommodative power after surgery.
Collapse
|
3
|
Nanavaty MA, Zukaite I, Salvage J. Edge profile of commercially available square-edged intraocular lenses: Part 2. J Cataract Refract Surg 2019; 45:847-853. [PMID: 30929976 DOI: 10.1016/j.jcrs.2018.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 11/27/2018] [Accepted: 12/03/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To analyze the sharpness of the posterior optic edge and edge thickness of intraocular lenses (IOLs) marketed with a square-edged profile. SETTING University of Brighton and Brighton and Sussex University Hospitals NHS Trust, Brighton, England. DESIGN Laboratory study. METHODS Fourteen square-edged 20.0 diopter IOLs were analyzed, including 9 hydrophobic IOLs (AF-1, AF-1 iSert, Clareon, EyeCee One Crystal, CT Lucia, Envista, EyeCee One, Vivinex iSert, and RayOne Hydrophobic) and 5 hydrophilic IOLs (Asphira, CT Asphina, Incise, Synthesis, and RayOne Hydrophilic). All the IOLs were scanned following a previously published standardized technique using environmental scanning electron microscopy. The posterior optic edges were scanned at a magnification of ×500 and ×200 to measure the radius of curvature of the posterior optic edges and the optic edge thickness. RESULTS The radius of curvature of the posterior optic edges ranged from 4.6 to 20.6 μm. Except for the Incise IOL (7.7 μm), all hydrophilic IOLs (Synthesis [10.6 μm], Asphira [13.7 μm], RayOne Hydrophilic [14.0 μm], CT Asphina [13.7 μm]) had a radius of curvature greater than 10.0 μm. For the hydrophobic IOLs, the radius of curvature was less than 10.0 μm for the Clareon (7.9 μm), EyeCee One Crystal (4.7 μm), Vivinex iSert (7.6 μm), and CT Lucia (4.6 μm), and greater than 10.0 μm for the Envista (19.7 μm), EyeCee One (13.7 μm), AF-1 iSert (19.7 μm), AF-1 (19.7 μm) and the RayOne Hydrophobic (20.6 μm). The Vivinex iSert (150.5 μm) and the Incise (218.2 μm) were the thinnest IOLs, and the RayOne Hydrophobic (375.8 μm) and RayOne Hydrophilic IOLs (477.1 μm) were the thickest of the hydrophobic and hydrophilic IOLs, respectively. CONCLUSIONS Commercially marketed square-edged IOLs still differed in the sharpness of the posterior optic edge. More hydrophobic IOLs have rounder edges than those studied 10 years ago. Variations in the edge profile of hydrophobic IOLs were greater compared with the hydrophilic IOLs.
Collapse
Affiliation(s)
- Mayank A Nanavaty
- Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, England; Brighton and Sussex Medical School, University of Sussex, Falmer, England.
| | - Ieva Zukaite
- Sussex Eye Hospital, Brighton and Sussex University Hospitals NHS Trust, Brighton, England; Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | | |
Collapse
|
4
|
Wang GQ, Dang YL, Huang Q, Woo VCP, So KF, Lai JSM, Cheng GPM, Chiu K. In Vitro Evaluation of the Effects of Intraocular Lens Material on Lens Epithelial Cell Proliferation, Migration, and Transformation. Curr Eye Res 2016; 42:72-78. [DOI: 10.3109/02713683.2016.1156133] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
5
|
Nanavaty MA, Spalton DJ, Boyce J, Brain A, Marshall J. Edge profile of commercially available square-edged intraocular lenses. J Cataract Refract Surg 2008; 34:677-86. [PMID: 18361993 DOI: 10.1016/j.jcrs.2007.12.024] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2007] [Accepted: 12/03/2007] [Indexed: 11/18/2022]
Abstract
PURPOSE To analyze the sharpness of the posterior optic edge profile and edge thickness of intraocular lenses (IOLs) marketed with a square-edged profile. SETTING Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom. METHODS Seventeen square-edged 20.0 diopter IOLs of different manufacture, design, and material were selected. After the environmental scanning electron microscopy technique was standardized, repeatability of the technique was tested. Posterior optic edges of all IOLs were scanned at a magnification of x 500. Local radii of curvature of the posterior optic edges were measured by purpose-designed software. Optic edge thickness was also measured from the electron micrographs. RESULTS The repeatability of the scanning technique was excellent (+/-0.10 microm). The radius of curvature of posterior optic edges ranged from 7.6 to 23.1 microm. Hydrophilic acrylic IOLs (except the HumanOptics MC Microlens 611 MI-B and 1CU) had radii of curvatures more than 10.0 microm of the posterior optic edge compared with hydrophobic acrylic and silicone IOLs (<10.0 microm) except the Hoya AF-1 (19.9 microm). Alcon AcrySof single-piece (SN60WF), HumanOptics 1CU, and AMO Clariflex CLRFLXC IOLs had the thinnest optic edges in the hydrophobic, hydrophilic, and silicone groups, respectively. CONCLUSIONS Commercially marketed square-edged IOLs differed in the sharpness of the posterior optic edge. Hydrophobic acrylic and silicone IOLs have sharper posterior optic square edge than most hydrophilic acrylic IOLs. This probably reflects difference in manufacturing techniques. Differences in posterior optic edge profile may explain variation in posterior capsule opacification performance with different IOLs and materials.
Collapse
Affiliation(s)
- Mayank A Nanavaty
- Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom
| | | | | | | | | |
Collapse
|
6
|
Nguyen DQ, Saleh TA, Pandey SK, Bates AK. Irregularities on the surface of single-piece AcrySof SA60AT intraocular lenses. J Cataract Refract Surg 2006; 32:495-8. [PMID: 16631064 DOI: 10.1016/j.jcrs.2005.12.074] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2005] [Accepted: 07/19/2005] [Indexed: 11/17/2022]
Abstract
PURPOSE To report a case series of what initially appeared to be macroscopic biomaterial deposits and irregularities on the surface of AcrySof SA60AT intraocular lenses (IOLs) (Alcon Inc.) SETTING Department of Ophthalmology and Somerset Hospital, Taunton, United Kingdom; Department of Ophthalmology and Visual Sciences, John A Moran Eye Center, University of Utah, Salt Lake City, Utah, USA; and Intraocular Implant Unit, Sydney Eye Hospital, University of Sydney, Sydney, Australia. METHODS Twelve AcrySof SA60AT IOLs were initially thought to have irregularities on their surfaces when examined under the operating microscope before implantation in the capsular bag during cataract surgery. The IOLs were sent for further analysis, including gross examination and light and scanning electron microscopy, to John A. Moran Eye Center, Salt Lake City, Utah, USA, and to Alcon Laboratories, Hemel Hempstead, United Kingdom. RESULTS Light microscopy revealed the presence of irregular fine lesions on the IOLs' optics and haptics. The lesions consisted of elevations and depressions of the IOL surface that were present on both the anterior and the posterior surfaces of the IOLs. Scanning electron microscopy confirmed the presence of physical/mechanical damage to the IOLs, which was thought to originate from the packaging. The manufacturer believed this to have resulted from compression of the IOL between the container and its cover. CONCLUSIONS Implantation of an imperfect IOL remains a potentially serious occurrence. Faults still occur in modern IOLs, and some defects can be detected by examining the IOL under the operating microscope before implantation into the eye.
Collapse
Affiliation(s)
- Dan Q Nguyen
- Department of Ophthalmology, Taunton and Somerset Hospital, Taunton, United Kingdom
| | | | | | | |
Collapse
|
7
|
Mencucci R, Ponchietti C, Nocentini L, Danielli D, Menchini U. Scanning electron microscopic analysis of acrylic intraocular lenses for microincision cataract surgery. J Cataract Refract Surg 2006; 32:318-23. [PMID: 16565011 DOI: 10.1016/j.jcrs.2005.12.131] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2005] [Accepted: 07/03/2005] [Indexed: 11/26/2022]
Abstract
PURPOSE To analyze the surface quality before and after folding of 2 intraocular lens (IOL) models designed for microincision cataract surgery. SETTING Eye Clinic and Department of Human Pathology and Oncology, University of Florence, Florence, Italy. METHODS Two IOL models now available for sub-2.0 mm microincision were studied: UltraChoice 1.0 Rollable ThinLens (ultrathin lens by ThinOptX) and AcriSmart (foldable lens by AcriTec). Eight IOLs of each model were examined. Scanning electron microscopy (SEM) was performed before and after IOL folding with a dedicated injector. Special attention was given to the optic surface and edges, the optic-haptic junction, and the haptic itself. RESULTS Initially, the surface quality of IOLs was evaluated before folding. On SEM, smooth and homogeneous optic and haptic surfaces were revealed in both IOL models with no surplus material or molding flashes; edge finish of all optics showed no evidence of ridges. The IOL surfaces were evaluated after insertion into their injectors and after ejection at room temperature. After folding, the microincision IOLs showed no sign of surface alteration, probably because of their high water content, which makes these IOLs soft and flexible. CONCLUSIONS Visual results and long-term biocompatibility of the IOLs are influenced by surface properties. In recent years, there has been a trend toward microincision cataract surgery. Our study shows that the 2 IOL models now available for sub-2.0 mm microincision have acceptable surface properties.
Collapse
Affiliation(s)
- Rita Mencucci
- Department of Oto-Neuro-Ophthalmological Surgical Sciences-Eye Clinic, University of Florence, Florence, Italy.
| | | | | | | | | |
Collapse
|
8
|
Mencucci R, Dei R, Danielli D, Susini M, Menchini U. Folding procedure for acrylic intraocular lenses. J Cataract Refract Surg 2004; 30:457-63. [PMID: 15030842 DOI: 10.1016/j.jcrs.2003.11.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2003] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare in vitro the effect of 2 standard methods of folding acrylic intraocular lenses (IOLs) on surface characteristics and bacterial adhesion. SETTING Eye Clinic and Department of Health-Microbiology Unit, University of Florence, Florence, Italy. METHODS To evaluate the effect of folding, 2 types of acrylic IOLs were not folded or folded with a forceps or an injector and then processed for scanning electron microscopy (SEM) examination. Bacterial adhesion was assessed using an ocular isolate of Pseudomonas aeruginosa. Nonfolded and folded IOLs were placed in test tubes containing the bacterial suspension for direct counting of viable adherent bacteria and for SEM. RESULTS The injector-folded IOLs did not show major alterations on the surface; 5 of the 9 forceps-folded IOLs showed marks or scratches in the profile of the optic. The mean number of viable adherent bacteria per area of IOL optic was 1082 (95% confidence interval [CI], 835-1330) in forceps-folded IOLs, 366 (95% CI, 192-359) in injector-folded IOLs, and 206 (95% CI, 123-289) in nonfolded IOLs. Scanning electron microscopy confirmed more surface irregularities on forceps-folded IOLs, with bacteria adherent preferentially on the surface scratches. CONCLUSION Forceps-folding provoked more surface irregularities, which probably make IOLs more susceptible to bacterial adhesion.
Collapse
Affiliation(s)
- Rita Mencucci
- Department of Oto-Neuro-Ophthalmological Surgical Sciences-2nd Eye Clinic, University of Florence, Florence, Italy.
| | | | | | | | | |
Collapse
|
9
|
Escobar-Gomez M, Apple DJ, Vargas LG, Werner L, Arthur SN, Pandey SK, Izak AM, Schmidbauer JM. Scanning electron microscopic and histologic evaluation of the AcrySof SA30AL acrylic intraocular lens. Manufacturing quality and morphology in the capsular bag. J Cataract Refract Surg 2003; 29:164-9. [PMID: 12551685 DOI: 10.1016/s0886-3350(02)01435-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To evaluate the properties of the AcrySof(R) SA30AL (Alcon Laboratories, Inc.) single-piece foldable posterior chamber intraocular lens (IOL). SETTING Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA. METHODS Two nonimplanted clinical-quality AcrySof IOLs were examined by gross, light, and scanning electron microscopy (SEM). In addition, 2 eyes implanted with this IOL obtained post-mortem, the first such eyes accessioned in our laboratory and the first described to date, were examined using the Miyake-Apple posterior photographic technique and by histologic sections. RESULTS Scanning electron microscopy of the SA30AL IOL showed excellent surface finish. The edge of the optic was square (truncated) and had a matte (velvet or ground-glass) appearance, a feature that may minimize edge glare and other visual phenomena. A well-fabricated square or truncated optic edge was demonstrated. Miyake-Apple analysis revealed that the SA30AL IOL showed appropriate fit and configuration within the capsular bag. Histologic correlation of the IOL's square edge and its relation to the capsular bag and adjacent Soemmering's ring were noted. CONCLUSIONS The AcrySof SA30AL IOL is a well-fabricated lens that situates well in the capsular bag. The truncated optic and its relationship to adjacent structures show a morphological profile that has been shown to be highly efficacious in reducing the rate of posterior capsule opacification.
Collapse
Affiliation(s)
- Marcela Escobar-Gomez
- Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Hwang IP, Olson RJ. Patient satisfaction after uneventful cataract surgery with implantation of a silicone or acrylic foldable intraocular lens. Comparative study. J Cataract Refract Surg 2001; 27:1607-10. [PMID: 11687359 DOI: 10.1016/s0886-3350(01)00897-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare patient satisfaction with vision 12 months after implantation of a silicone or acrylic foldable intraocular lens (IOL). SETTING John A. Moran Eye Center, University of Utah Medical Center, Salt Lake City, Utah, USA. METHODS Selection criteria included patients who had uneventful cataract extraction by phacoemulsification with a temporal clear corneal incision or superior scleral tunnel incision, a curvilinear capsulorhexis, and in-the-bag IOL placement. One hundred sixty-two patients surveyed had a mean follow-up of approximately 15 months (range 12 to 18 months). Patients were divided into 3 groups of 54 each based on IOL type: AMO SI-30/40, Alcon MA30BA, and Alcon MA60BA. All patients were surveyed over the telephone using a standardized questionnaire protocol. They were questioned about their perception of vision with best optical correction in relation to visual blurring symptoms, glare symptoms, night vision, near vision, and overall vision. RESULTS There were no significant differences in patient satisfaction among the 3 IOL groups in visual blurring or night vision. Patients in the SI-30/40 and MA60BA groups reported significantly higher satisfaction with glare symptoms, near vision, and overall satisfaction than patients in the MA30BA group. CONCLUSION The SI-30/SI-40 and the MA60BA IOLs received significantly higher patient satisfaction scores than the MA30BA IOL in glare symptoms, near vision, and overall satisfaction.
Collapse
Affiliation(s)
- I P Hwang
- Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah 84132, USA
| | | |
Collapse
|
11
|
Harstall C. Comparison of monofocal intraocular lenses for uncomplicated age-related cataract. Can J Ophthalmol 2001; 36:127-32; discussion 132-3. [PMID: 11367583 DOI: 10.1016/s0008-4182(01)80003-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
12
|
Cataract Surgery With Rigid and Foldable Posterior Chamber IOLs, ECCE and Phacoemulsification. Surv Ophthalmol 2000. [DOI: 10.1016/s0039-6257(00)00172-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
13
|
|
14
|
Tognetto D, Toto L, Ravalico G. Pit defects on the anterior surface of hydrophilic foldable intraocular lenses. J Cataract Refract Surg 2000; 26:1560-4. [PMID: 11033409 DOI: 10.1016/s0886-3350(00)00415-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A series of pits varying in depth and size appeared on the anterior surface of hydrogel intraocular lenses (IOLs) soon after they were implanted. In all cases, the pits increased in size but not in number during a 1 year follow-up. The origin of the pit defects is unknown and does not seem related to inflammatory or lens epithelial cell activity. Hydration of the IOL could be a cause even if a manufacturing defect were present. This IOL surface alteration did not seem to impair visual function or cause visual disturbances.
Collapse
Affiliation(s)
- D Tognetto
- Eye Clinic, University of Trieste, Trieste, Italy
| | | | | |
Collapse
|
15
|
Farbowitz MA, Zabriskie NA, Crandall AS, Olson RJ, Miller KM. Visual complaints associated with the AcrySof acrylic intraocular lens(1). J Cataract Refract Surg 2000; 26:1339-45. [PMID: 11020619 DOI: 10.1016/s0886-3350(00)00441-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To describe the visual complaints of a series of patients implanted with the AcrySof(R) (Alcon Surgical) acrylic intraocular lens (IOL) that resolved with IOL exchange. SETTING Jules Stein Eye Institute, Los Angeles, California, and John A. Moran Eye Center, Salt Lake City, Utah, USA. METHODS This was a retrospective review of patients who had AcrySof IOL exchange from January 1997 to December 1998. RESULTS Eight patients (9 eyes) with bothersome visual symptoms following AcrySof IOL implantation were identified. Problems included glare, halos around point light sources, and peripheral arcs of light, often worse at night. In each case, the IOL was well-centered in the capsular bag and there was no significant posterior capsule opacification. Six patients (7 eyes) had the MA30BA model with a 5.5 mm optic, and 2 patients (2 eyes) had the MA60BM model with a 6.0 mm optic. No extralenticular reasons for the patients' complaints could be identified. Exchanging the AcrySof IOLs with silicone or poly(methyl methacrylate) IOLs alleviated most symptoms. In 5 of 8 patients, dysphotopsias resolved completely. CONCLUSIONS A small number of patients implanted with AcrySof IOLs have specific complaints of glare, halos, and peripheral arcs of light. Optical considerations that may help explain these symptoms include the high refractive index of the IOL material and the truncated design of the optic. Patients who are highly observant and those with large pupils may be particularly symptomatic. Intraocular lens exchange may be necessary in some cases.
Collapse
Affiliation(s)
- M A Farbowitz
- Department of Ophthalmology, UCLA School of Medicine, and the Jules Stein Eye Institute, Los Angeles, California 90095-7002, USA
| | | | | | | | | |
Collapse
|
16
|
Kohnen T, Baumeister M, Magdowski G. Scanning electron microscopic characteristics of phakic intraocular lenses. Ophthalmology 2000; 107:934-9. [PMID: 10811086 DOI: 10.1016/s0161-6420(00)00072-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To analyze the surface quality of new generation phakic intraocular lenses (IOLs). DESIGN Experimental materials study. MATERIALS Three different new generation phakic IOLs: angle-fixated anterior chamber lens Chiron Vision NuVita MA20 (polymethylmethacrylate [PMMAD, iris-fixated anterior chamber lens Ophtec Artisan Iris-Claw (PMMA), posterior chamber lens Staar ICM (polymer from porcine collagen and 2-hydroxyethyl methacrylate [HEMA]). METHODS Representative samples of three different phakic IOLs underwent surface and edge-finish examination with light microscopy (LM). The phakic IOLs were then examined by use of scanning electron microscopy (SEM), and particular attention was given to optic surface quality, edge finish, haptic, and optic/haptic junction. RESULTS In all IOLs the LM examination showed a smooth and homogeneous surface. No irregularities, particularly at the optic front and back surface, optic edge, haptic, and the optic/haptic junctions, were detected by SEM. One exception was a minor surface roughness at the claws of an Artisan iris-fixated anterior chamber IOL. CONCLUSIONS Phakic IOLs are implanted either in the anterior or posterior chamber of healthy eyes, and high standards for their surface quality are required. The evaluation of surface properties with LM and SEM did not reveal any defects that contraindicate the implantation of phakic IOLs.
Collapse
Affiliation(s)
- T Kohnen
- Department of Ophthalmology, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | | | | |
Collapse
|
17
|
Peng Q, Visessook N, Apple DJ, Pandey SK, Werner L, Escobar-Gomez M, Schoderbek R, Solomon KD, Guindi A. Surgical prevention of posterior capsule opacification. Part 3: Intraocular lens optic barrier effect as a second line of defense. J Cataract Refract Surg 2000; 26:198-213. [PMID: 10683787 DOI: 10.1016/s0886-3350(99)00352-1] [Citation(s) in RCA: 161] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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 extra-capsular 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.
Collapse
Affiliation(s)
- Q Peng
- Department of Ophthalmology, Medical University of South Carolina, Charleston 29425-2236, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Häring G, Winter M, Behrendt S. Effect of folding on the multifocal silicone intraocular lens: scanning electron microscopic study. J Cataract Refract Surg 1999; 25:1505-9. [PMID: 10569166 DOI: 10.1016/s0886-3350(99)00240-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate whether the surface of the refractive zonal multifocal silicone intraocular lens (IOL) is altered by different folding and implantation instruments and is more sensitive to manipulation during folding than the surface of a monofocal IOL. SETTING Department of Ophthalmology, University Hospital, Kiel, Germany. METHODS Evaluated were the refractive multifocal silicone IOL (SA-40N, Array) and an otherwise identical monofocal IOL (SI-40NB) from the same manufacturer (Allergan Inc.). Different folding devices (folding blocks, folding and implantation forceps, and an injector system) were used. The IOLs were kept folded for 60 seconds; 24 hours later, scanning electron microscopy (SEM) was performed. In addition, the cartridges of the injector system were examined by SEM. RESULTS Overall, regardless of the folding and implantation instruments used, both the multifocal and monofocal IOLs had discrete surface alterations. The cartridges of the injector system had a rough surface at the tip, while the proximal portion appeared smooth. CONCLUSION There were no signs of lesions particularly affecting the surface of multifocal IOLs.
Collapse
Affiliation(s)
- G Häring
- Department of Ophthalmology, Christian-Albrechts-University, Kiel, Germany
| | | | | |
Collapse
|
19
|
Hayashi H, Oshima K. Low-vacuum, low-voltage scanning electron microscopy of poly(methyl methacrylate) intraocular lenses. J Cataract Refract Surg 1998; 24:385-9. [PMID: 9559476 DOI: 10.1016/s0886-3350(98)80328-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To evaluate the usefulness of low-vacuum, low-voltage scanning electron microscopy (LVSEM) in examining the surfaces of intraocular lenses (IOLs) without preparation. SETTING In vitro laboratory experiment. METHODS Six commercially available IOLs made of poly(methyl methacrylate) (PMMA) and one explanted PMMA IOL were evaluated with LVSEM without sputter coating. Sham surgical maneuvers were performed on some IOLs and the surface changes observed. RESULTS Smooth surfaces of IOL optics and haptics, relatively sharp edges of optic holes, and irregularities at the optic/haptic junction were clearly observed. Crystalline deposits were seen on the surfaces after the IOLs were dipped and dried in saline solution. Scratches and marks were observed after they were grasped with a forceps. CONCLUSIONS Low-vacuum, low-voltage scanning electron microscopy is a time-saving procedure that can be used by inexperienced investigators. The resolution under relatively low magnification appeared to be satisfactory for evaluating the IOL surface.
Collapse
Affiliation(s)
- H Hayashi
- Department of Ophthalmology, School of Medicine, Fukuoka University, Japan
| | | |
Collapse
|
20
|
Kohnen T, Magdowski G, Koch DD. Scanning electron microscopic analysis of foldable acrylic and hydrogel intraocular lenses. J Cataract Refract Surg 1996; 22 Suppl 2:1342-50. [PMID: 9051527 DOI: 10.1016/s0886-3350(96)80095-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To analyze the surface quality of foldable acrylic and hydrogel intraocular lenses (IOLs). SETTING Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, and Institute of Anatomy and Cellular Biology, University of Giessen, Germany. METHODS We studied eight foldable IOL models with optics made of six different acrylate/methacrylate polymers: Acrylens ACR360 (loptex), AcrySof MA60BM (Alcon), MemoryLens U940A (Mentor), 92S and 92C (Morcher), Hydroview H60M (Storz), HydroSof SH30BC (Alcon), and ISH66 (Corneal). Four IOLs of each design were examined. Light and scanning electron microscopy were performed before and after IOL folding with forceps. RESULTS All IOL models had excellent optic and haptic surfaces. The haptic-optic junctions revealed minimal empty spaces or irregularities in three of the five three-piece IOLs and smooth surfaces in all one-piece IOLs. Minimal surface alterations and superficial defects caused by folding were detectable in the two acrylate (acrylic) IOLs (loptex ACR360, Alcon MA60BM) with low water content. CONCLUSION Intraocular lenses of acrylate/methacrylate polymers had excellent surface quality. The acrylic IOLs were vulnerable to mild folding or forceps defects; however, these were less marked than those previously noted with poly(methyl methacrylate) IOLs.
Collapse
Affiliation(s)
- T Kohnen
- Cullen Eye Institute, Baylor College of Medicine, Department of Ophthalmology, Houston, Texas 77030, USA
| | | | | |
Collapse
|