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In vivo digital imaging of the square-edged barrier effect of a silicone intraocular lens.
J Cataract Refract Surg. 2004 Dec; 30(12):2574-84.JC

Abstract

PURPOSE

To evaluate and compare by high-magnification digital photography the lens epithelial cell (LEC) response and capsule dynamics in vivo after implantation of a square-edged and a round-edged silicone intraocular lens (IOL) in a fellow-eye study.

SETTING

Private practice and Royal Victoria Hospital, Barrie, and Soldiers' Memorial Hospital, Orillia, Ontario, Canada.

METHODS

After phacoemulsification, a single surgeon implanted a square-edged silicone IOL (SoFlex SE, Bausch & Lomb) in 25 patients who had previously had a conventional round-edged version of the same IOL (SoFlex Li61U, Bausch & Lomb) implanted in their contralateral eye within a 6-week period. SoFlex SE IOL recipients were selected sequentially from those scheduled for surgery within a 3-day period. The IOLs were sequentially photographed 1 week and 1, 3, 6, and 9 months after surgery using magnification of at least x64 through a biomicroscope and a high-resolution digital camera with adapter. Images were transferred to a graphics computer and compared over time.

RESULTS

At 1 week, both designs had evidence of LEC migration along the posterior capsule, with the highest cell density around the 6 o'clock position. At 1 month, both IOL designs showed 360 degrees of anterior and posterior capsule adhesion to the edge of the optic. At 1 month, however, migrating LECs encountered a "damming" effect at the square posterior edge but not at the round edge. A thin fibrotic ring began to form around the SoFlex SE edge at 2 months and was complete for 360 degrees at 3 months. At 9 months, there was no evidence of LEC migration beyond this ring. With round-edged IOLs, the fibrotic ring never fully formed and LEC migration continued posterior to the optic. There was a tight capsule shrink-wrap effect with the square-edged IOLs with the fibrotic ring, allowing minimal IOL movement between 1 month and 9 months. The round-edged IOLs tended to decenter and rotate. Anterior capsulorhexis contraction was greater at every time point with the round-edged IOLs than with the square-edged IOLs.

CONCLUSION

Early contact inhibition of LECs by a square-edged IOL design and its effects were demonstrated in vivo with sequential, high-resolution digital photography and commercially available graphics software.

Authors+Show Affiliations

Royal Victoria Hospital, Barrie, Canada. trimedeyedoc@rogers.com

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15617927

Citation

Nixon, Donald R.. "In Vivo Digital Imaging of the Square-edged Barrier Effect of a Silicone Intraocular Lens." Journal of Cataract and Refractive Surgery, vol. 30, no. 12, 2004, pp. 2574-84.
Nixon DR. In vivo digital imaging of the square-edged barrier effect of a silicone intraocular lens. J Cataract Refract Surg. 2004;30(12):2574-84.
Nixon, D. R. (2004). In vivo digital imaging of the square-edged barrier effect of a silicone intraocular lens. Journal of Cataract and Refractive Surgery, 30(12), 2574-84.
Nixon DR. In Vivo Digital Imaging of the Square-edged Barrier Effect of a Silicone Intraocular Lens. J Cataract Refract Surg. 2004;30(12):2574-84. PubMed PMID: 15617927.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - In vivo digital imaging of the square-edged barrier effect of a silicone intraocular lens. A1 - Nixon,Donald R, PY - 2004/06/16/accepted PY - 2004/12/25/pubmed PY - 2005/3/8/medline PY - 2004/12/25/entrez SP - 2574 EP - 84 JF - Journal of cataract and refractive surgery JO - J Cataract Refract Surg VL - 30 IS - 12 N2 - PURPOSE: To evaluate and compare by high-magnification digital photography the lens epithelial cell (LEC) response and capsule dynamics in vivo after implantation of a square-edged and a round-edged silicone intraocular lens (IOL) in a fellow-eye study. SETTING: Private practice and Royal Victoria Hospital, Barrie, and Soldiers' Memorial Hospital, Orillia, Ontario, Canada. METHODS: After phacoemulsification, a single surgeon implanted a square-edged silicone IOL (SoFlex SE, Bausch & Lomb) in 25 patients who had previously had a conventional round-edged version of the same IOL (SoFlex Li61U, Bausch & Lomb) implanted in their contralateral eye within a 6-week period. SoFlex SE IOL recipients were selected sequentially from those scheduled for surgery within a 3-day period. The IOLs were sequentially photographed 1 week and 1, 3, 6, and 9 months after surgery using magnification of at least x64 through a biomicroscope and a high-resolution digital camera with adapter. Images were transferred to a graphics computer and compared over time. RESULTS: At 1 week, both designs had evidence of LEC migration along the posterior capsule, with the highest cell density around the 6 o'clock position. At 1 month, both IOL designs showed 360 degrees of anterior and posterior capsule adhesion to the edge of the optic. At 1 month, however, migrating LECs encountered a "damming" effect at the square posterior edge but not at the round edge. A thin fibrotic ring began to form around the SoFlex SE edge at 2 months and was complete for 360 degrees at 3 months. At 9 months, there was no evidence of LEC migration beyond this ring. With round-edged IOLs, the fibrotic ring never fully formed and LEC migration continued posterior to the optic. There was a tight capsule shrink-wrap effect with the square-edged IOLs with the fibrotic ring, allowing minimal IOL movement between 1 month and 9 months. The round-edged IOLs tended to decenter and rotate. Anterior capsulorhexis contraction was greater at every time point with the round-edged IOLs than with the square-edged IOLs. CONCLUSION: Early contact inhibition of LECs by a square-edged IOL design and its effects were demonstrated in vivo with sequential, high-resolution digital photography and commercially available graphics software. SN - 0886-3350 UR - https://www.unboundmedicine.com/medline/citation/15617927/In_vivo_digital_imaging_of_the_square_edged_barrier_effect_of_a_silicone_intraocular_lens_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0886-3350(04)00712-6 DB - PRIME DP - Unbound Medicine ER -