Intraocular lens extraction using the cartridge pull-through technique

Background. After cataract surgery, some lens epithelial cells (LECs) transdifferentiate into myofibroblast-like cells, which causes fibric posterior capsule opacification (PCO). Residual LECs differentiate into lens fiber cells, forming Elschnig pearls with PCO. This study was carried out to identify the time course of both types of LEC behavior in rabbit eyes following lens extraction and implantation of an intraocular lens (IOL). Methods. Phacoemulsification and implantation of posterior chamber IOLs were performed in rabbit eyes. Following enucleation, immunohistochemical methods were used to detect α-smooth muscle actin (α-SMA), a marker for myofibroblast-like cells, in the pseudophakic rabbit eyes. A mouse monoclonal antibody against α-SMA was used. Results. Soon after the operation, the LECs migrated and covered the lens capsule. Thereafter, the LECs around the anterior capsular margin were always positive for α-SMA. However, the distributions of these cells were not consistent. In some specimens, α-SMA-positive LECs were present around the IOL optic early after surgery, but most of them had disappeared several weeks after the surgery. The residual cells induced fibrotic PCO. In the other specimens, most LECs around the IOL optic except the anterior capsular margin were negative for α-SMA. In the peripheral region covered by the peripheral anterior and posterior capsules, LECs on the posterior capsule always differentiated into lens fiber cells and formed a Soemmering ring. Thereafter, migration of lens fiber cells from the Soemmering ring and differentiation of LECs in situ on the central posterior capsule consisted of Elschnig pearls type of PCO. Conclusions. Although postoperative LEC behavior is not consistent, residual α-SMA-positive LECs induced fibrotic PCO. The lens fiber cells that migrated from the peripheral capsular bag or that were differentiated in situ covered the central posterior capsule, forming Elschnig pearls with PCO.

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Clear lens extraction and intraocular lens implantation in a case of microspherophakia with secondary angle closure glaucoma

Indian Journal of Ophthalmology ◽

10.4103/0301-4738.58477 ◽

2010 ◽

Vol 58 (1) ◽

pp. 67 ◽

Cited By ~ 3

Author(s):

Jnanankar Medhi ◽

Sushobhan DasGupta ◽

Harsha Bhattacharjee ◽

Kasturi Bhattacharjee

Keyword(s):

Intraocular Lens ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Intraocular Lens Implantation ◽

Lens Extraction ◽

Lens Implantation

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Nitric oxide levels in aqueous humor after lens extraction and poly(methyl methacrylate) and foldable acrylic intraocular lens implantation in rabbit eyes

Journal of Cataract & Refractive Surgery ◽

10.1016/s0886-3350(02)01521-3 ◽

2002 ◽

Vol 28 (12) ◽

pp. 2188-2192 ◽

Cited By ~ 1

Author(s):

Piotr Jurowski ◽

Roman Goś ◽

Grażyna Piasecka

Keyword(s):

Nitric Oxide ◽

Methyl Methacrylate ◽

Aqueous Humor ◽

Intraocular Lens ◽

Intraocular Lens Implantation ◽

Poly Methyl Methacrylate ◽

Lens Extraction ◽

Lens Implantation

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Update on Paediatric Refractive Surgery

European Ophthalmic Review ◽

10.17925/eor.2015.09.02.104 ◽

2015 ◽

Vol 09 (02) ◽

pp. 104

Author(s):

Amir Pirouzian ◽

◽

Hesam Hashemian ◽

...

Keyword(s):

Intraocular Lens ◽

Refractive Surgery ◽

Case Reports ◽

Age Groups ◽

Cross Linking ◽

Posterior Chamber ◽

Original Research ◽

Phakic Intraocular Lens ◽

Lens Extraction ◽

Accommodative Esotropia

Purpose:To provide a summary of the most recent evidence-based data on the paediatric refractive surgery.Methods:A review of the published studies from 1990 to 2015 was undertaken with emphasis on recent articles from 2010 to 2015.Results:Searching Scopus and PubMed, using the keywords of refractive surgery, phakic, paediatric, IOL, children and amblyopia alone or in various combinations yielded a total of about 48 articles on this topic from 1990 to 2015. Excluding review articles, fewer than 35 articles were included. Original research articles were only in the form of case reports/series on corneal laser surgery and phakic intraocular lens implantation or clear lens extraction. A total of fewer than 800 patients and 700 eyes had undergone a form of refractive surgery listed above. No randomised clinical trial (RCT) study was available on the topic. Age varied from 7 months to 17 years for non-corneal cross-linking studies. Most commonly performed operations were corneal laser ablative procedures (photorefractive keratectomy [PRK], laser-assisted sub-epithelial keratectomy [LASEK], laser-assistedin situkeratomileusis [LASIK]), phakic intraocular lens implantations (p-IOL, anterior or posterior chamber) and clear lens extraction. The indications for surgical intervention were for refractive – high amplitude iso-ametropic or anisometropic – amblyopia in the setting of the previously failed medical interventions and spectacle intolerance or non-compliance (physical or neurobehavioral in nature) and high accommodative esotropia with/without amblyopia. The main objective of the studies was to assess for visual acuity gained or lost following surgery and for correction of strabismus, i.e. achieving orthophoria. Further search on the keywords ‘cross-linking, cornea, rings and children’ from the same databases resulted in 130 articles. No RCT study was available on the topic. Age varied from 7 months to 17 years for non-corneal cross-linking studies. The focus of the most recent refractive surgery articles has been on the treatment and stabilisation of irregular myopic astigmatism from kerato-ectatic conditions by means of corneal cross-linking and intrastromal ring/in-lay implantation.Discussion:Refractive surgery remains a controversial topic in paediatric age population. However, the evidence clearly supports refractive surgery for treatment of children with refractive amblyopia and for treatment of accommodative esotropia in children unable or unwilling to wear spectacles or contact lenses.Conclusion:Consensus exists among published authors that refractive surgery may be considered in children with refractive amblyopia after exhausting various therapeutic medical options for amblyopia. Published authors have universally endorsed undertaking prospective multi-centred RCTs to conclusively establish the long-term safety and efficacy of various types of refractive surgery in the paediatric patients of different age groups.

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