Comparison of the capsule biocompatibility of three types of intraocular lenses in vitro / 中华实验眼科杂志

Background Researchers showed that posterior capsule opacification (PCO) may be associated with the materials of intraocular lenses (IOLs).However,there have long been controversies about the influence of IOLs materials on PCO pathogenesis.Objective This study was to compare the capsule biocompatibility of different materials of IOLs by observing the biological behavior of human lens epithelial cells (LECs) on the surface of IOLs,including adhesion,proliferation,epithelial mesenchymal transition (EMT) and the secretion of transforming growth factor-β2(TGF-β2),interleukin-6 (IL-6),matrix metalloproteinase-2 (MMP-2) and MMP-9 in vitro.Methods Human lens epithelial cell line (HLE-B3) was cultured on the surface of hydrophobic acrylic (Acrysof SA60AT) IOLs,silicone (Crystalens HD) IOLs and polymethyl methacrylate (PMMA) IOLs for 6 hours and 24 hours,respectively.The number and morphology of HLE-B3 cells on the surface of IOLs were observed under the optical microscope.The proliferation states of the cells on the IOL surface were detected with cell counting kit-8 (CCK-8).The expression of α-smooth muscle actin (α-SMA),a mesenchymal cell marker,in the cells was detected by immunofluoreseence technology,and the EMT rates of HLE-B3 cells were calculated.The contents of TGF-β2,IL-6,MMP-2 and MMP-9 in the medium of IOL surface were measured by ELISA assay.The examination results were compared among different IOLs.Results Six hours after cultured,attached cells showed polygon and round in shape on the surface of Acrysof IOLs and Crystalens IOLs,while those on the PMMA IOLs showed the fusiform.Twenty-four hours after cultured,the cells extended obviously.On the surface of Acrysof IOLs and Crystalens IOLs,the adherent cells showed less cobble-stone like and more spindle shape;while those on the PMMA IOLs showed the typical fiber and some cells clustered the pearl rolls.The number of the cells on the Acrysof IOLs,Crystalens IOLs and PMMA IOLs was 0.238 4 ± 0.007 1,0.178 1 ±-0.006 6 and 0.158 9 ± 0.006 9 respectively,showing a significant difference among the three types of IOLs (F =475.947,P =0.000),and the number of the cells was much more on the Acrysof IOLs than that on the Crystalens IOLs or PMMA IOLs (both at P＜0.001).The EMT rats of the cells on the Acrysof IOLs,Crystalens IOLs and PMMA IOLs were (9.99±3.80) ％,(17.33±5.71) ％ and (84.16±10.48) ％,with a significant difference among them (F =127.411,P =0.000),and the EMT rates of the cells on the PMMA IOLs were significantly higher than those on the Crystalens IOLs and A.crysof IOLs(both at P＜0.001).There were significant differences in the contents of TGF-β2,IL-6,MMP-2 and MMP-9 in the medium on the Acrysof IOLs,Crystalens IOLs and PMMA IOLs (F =0.846,0.947,0.255,0.922,all at P ＞ 0.05).Conclusions The hydrophobic acrylic IOLs have the best capsule biocompatibility followed by the silicone IOLs and then the PMMA IOLs.

Incidence of posterior capsule opacification following the implantation of a foldable hydrophilic acrylic intraocular lens: a 4 year follow-up study / Incidência da opacificação da cápsula posterior após o implante de uma lente intraocular acrílica hidrofílica dobrável: seguimento de 4 anos

Purpose: To evaluate the incidence of posterior capsule opacification (PCO) four years after the implantation of a hydrophilic acrylic intraocular lens (IOL). Methods: Fifty-eight randomly selected eyes from 58 patients were analyzed four years after phacoemulsification and Ioflex IOL implantation. The patients underwent an ophthalmic examination to detect PCO and a detailed medical history was obtained. The patients' charts were reviewed for their corrected distance visual acuity prior to the IOL implantation, as well as for one month postoperatively. The Student's t-test was used for statistical analysis. Results: The mean age of patients without PCO was 74.6 ± 9.5 years, compared to 70.3 ± 15 years in patients with PCO. Four years after surgery, 39 of the 58 eyes (67%) had detectable PCO and 24 eyes (41.3%) had decreased visual acuity (VA) due to PCO. These patients were referred for Nd:YAG laser capsulotomy. Three patients (5.1%) had decreased VA due to glaucoma, IOL opacification, or age-related macular degeneration. Twelve eyes (20.7%) presented mild PCO with unchanged VA. Systemic arterial hypertension was reported by 45% of the patients, and in 3.5% of these cases this was associated with diabetes mellitus. Conclusion: This study found the incidence of PCO to be 67% four years after phacoemulsification and Ioflex IOL implantation. .

Objetivo: Avaliar a incidência da opacificação da cápsula posterior com o implante de uma lente intraocular acrílica hidrofílica. Métodos: Cinquenta e oito olhos, de 58 pacientes, selecionados de forma aleatória, foram examinados 4 anos após a cirurgia de facoemulsificação com implante da lente intraocular Ioflex em uma campanha comunitária para pessoas carentes. Os pacientes foram submetidos ao exame oftalmológico a fim de detectar opacificação da cápsula posterior. Foi obtido histórico médico detalhado. A acuidade visual corrigida antes e 1 mês após a cirurgia foi obtida através de revisão em prontuário médico. O teste t de student foi utilizado para a análise estatística. Resultados: A idade média dos pacientes sem opacificação da cápsula posterior foi 74,6 ± 9,5 anos, e 70,3 ± 15 anos nos pacientes com opacificação da cápsula posterior. Após 4 anos da cirurgia, 39 olhos (67%) foram diagnosticados com opacificação da cápsula posterior, e 24 olhos (41,3%) tiveram redução da acuidade visual causada pela opacificação da cápsula posterior, sendo encaminhados para realização de capsulotomia com Nd:YAG laser. Três olhos (5,1%) tiveram redução da acuidade visual causada por glaucoma, opacificação da lente intraocular e degeneração macular relacionada á idade. Em outros 12 olhos (20,7%) que apresentaram opacificação da cápsula posterior, a acuidade visual ficou mantida. Dentre as doenças sistêmicas, a hipertensão arterial foi relatada por 45% da amostra avaliada e 3,5% referiram diabetes mellitus. Conclusão: O estudo encontrou incidência de 67% de opacificação da cápsula posterior na lente intraocular Ioflex 4 anos ...

Posterior Capsule Rupture during Phacoemulsification among Patients with Pseudoexfoliation–Is There A Correlation?

This study was done to correlate the occurrence of posterior capsule rupture among patients with pseudoexfoliation during phacoemulsification. This was a retrospective audit of patients who underwent phacoemulsification type cataract surgery from January 2011 to December 2012 in a tertiary hospital in Malaysia. Data was obtained from the National Eye Database (NED) of Malaysia. The data was analysed using SPSS version 21.0. By using logistic regression analysis, it was found that there was no significant increase in the occurrence of posterior capsule rupture among patients with pseudoexfoliation. Hence, we concluded that there was no correlation between the occurrence of posterior capsule rupture and the presence of pesudoexfoliation among patients who underwent phacoemulsification.