Effect of square-edged intraocular lenses on neodymium:YAG laser capsulotomy rates in the United States

Cleary, Georgia; Spalton, David J.; Koch, Douglas D.

doi:10.1016/j.jcrs.2007.06.056

Cited by 28 publications

(15 citation statements)

References 49 publications

(50 reference statements)

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“…However, in spite of these improvements about 10% of patients still require a Nd:YAG laser capsulotomy within 2 years of surgery and these numbers continue to rise with greater post-surgical time (Vock et al, 2009). This places a strain on healthcare resources, medical time and the quality of a patient's life (Cleary et al, 2007). These problems are exacerbated in paediatric eyes, eyes with inflammation or with multifocal IOLs.…”

Section: Introductionmentioning

confidence: 99%

Experimental models for posterior capsule opacification research

Wormstone

Eldred

2016

Experimental Eye Research

103

102

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Millions of people worldwide are blinded due to cataract formation. At present the only means of treating a cataract is through surgical intervention. A modern cataract operation involves the creation of an opening in the anterior lens capsule to allow access to the fibre cells, which are then removed. This leaves in place a capsular bag that comprises the remaining anterior capsule and the entire posterior capsule. In most cases, an intraocular lens is implanted into the capsular bag during surgery. This procedure initially generates good visual restoration, but unfortunately, residual lens epithelial cells undergo a wound-healing response invoked by surgery, which in time commonly results in a secondary loss of vision. This condition is known as posterior capsule opacification (PCO) and exhibits classical features of fibrosis, including hyperproliferation, migration, matrix deposition, matrix contraction and transdifferentiation into myofibroblasts. These changes alone can cause visual deterioration, but in a significant number of cases, fibre differentiation is also observed, which gives rise to Soemmering's ring and Elschnig's pearl formation. Elucidating the regulatory factors that govern these events is fundamental in the drive to develop future strategies to prevent or delay visual deterioration resulting from PCO. A range of experimental platforms are available for the study of PCO that range from in vivo animal models to in vitro human cell and tissue culture models. In the current review, we will highlight some of the experimental models used in PCO research and provide examples of key findings that have resulted from these approaches.

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Section: Introductionmentioning

confidence: 99%

Experimental models for posterior capsule opacification research

Wormstone

Eldred

2016

Experimental Eye Research

103

102

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“…a sharp IOL optic edge [10]. Although the use of sharp-edged IOLs initially appeared to reduce the prevalence of PCO, recent reports have shown that the need for neodymium:YAG (Nd:YAG) laser capsulotomy is not as low as expected, but instead postponed, and other means than the IOL design have to beconsidered to prevent PCO [11-13]. Extended knowledge about patient-associated risk factors could lead to ways of developing new preventive strategies.…”

Section: Introductionmentioning

confidence: 99%

In Vitro Growth of Lens Epithelial Cells from Cataract Patients - Association with Possible Risk Factors for Posterior Capsule Opacification

Sundelin¹,

Petersen²,

Soltanpour³

et al. 2014

TOOPHTJ

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Aim : Inter-individual differences in intrinsic proliferative capacity of lens epithelial cells may have importance for the risk of developing posterior capsule opacification (PCO) after cataract surgery. The purpose of the present study was to determine growth of human lens epithelial cells (HLEC) in culture and investigate possible associations with clinical characteristics of the donors, such as age, sex, pseudoexfoliation, uveitis and diabetes.Methods : Pieces of lens capsule and adhering lens epithelial cells were obtained through capsulorhexis at cataract surgery. Specimens were cultured in a humidified CO2-incubator using standard culture medium and 5% fetal calf serum for two weeks after which cultured cells were stained with carboxy-fluorescein diacetate succinimidyl ester. Image processing software was used to determine the area of the confluent epithelial cell layer in relation to the size of the original capsule specimen.Results : The increase in area of confluent HLEC showed a negative correlation with diabetes at the first week after surgery. Lower age and female sex showed border-line significant associations with a higher rate of cell proliferation. The presence of pseudoexfoliation in vivo did not significantly affect cell growth in culture postoperatively. Nor did installation of xylocain in the anterior chamber during surgery.Conclusion : Diabetes is associated with lower rate of proliferation of lens epithelial cells in culture. The lack of strong correlations between in vitro growth and known risk factors for PCO in the donors suggest that other factors than the proliferative capacity of the cells per se are important for PCO formation.

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“…In recent years, the introduction of sharp-edge optic IOL and the development of the modern phacoemulsification technique have resulted in reduced rates of PCO. (1)(2)(3) Standard treatment of the PCO is neodymium-doped yttrium aluminium garnet (Nd:YAG) laser capsulotomy. This procedure is effective but it has several complications such as postoperative intraocular pressure (IOP) elevation, IOL damage, inflammation, cystoid macular edema, and retinal detachment.…”

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confidence: 99%

Short-term effect of nd:yag laser capsulotomy on refraction, central macular thickness and retinal nerve fber layer thickness

Cevher¹,

Koçluk²,

Çetinkaya³

et al. 2017

Revista Brasileira De Oftalmologia

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Objective: The aim of this study is to examine the effect of Nd: YAG laser capsulotomy on refraction, central macular thickness (CMT) and retinal nerve fiber layer (RNFL ResumoObjetivo: O objetivo deste estudo é examinar o efeito da capsulotomia de laser Nd: YAG na refração, espessura macular central (CMT) e espessura da camada de fibra nervosa retiniana (RNFL). Métodos: 42 olhos de 42 pacientes que trataram com capsulotomia laser Nd: YAG foram incluídos neste estudo prospectivo. O equivalente esférico (SE), a refração de potência cíclica, a espessura CMT e RNFL foram avaliados pré-operatório e no primeiro dia pós-operatório, primeira semana e primeiro mês pós-operatório. Resultados: valores equivalentes esféricos e valores de espessura macular central não alteraram significativamente no primeiro mês após o tratamento. Os valores médios e da espessura da camada de fibra nervosa nasal da retina aumentaram significativamente e a refração do poder cíclico diminuiu significativamente durante as visitas. Conclusão: Nd: a capsulotomia laser YAG é uma opção de tratamento confiante e confiável da opacificação da cápsula posterior (PCO). Após Nd: a capsulotomia do laser YAG, a refração do poder cíclico e os valores da espessura do RNFL mudam significativamente.

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Effect of square-edged intraocular lenses on neodymium:YAG laser capsulotomy rates in the United States

Abstract: After the introduction of square-edged IOLs, Nd:YAG laser capsulotomy rates decreased, but not by as much as predicted. The additional cost to the Medicare system was more than US $30 million higher than the model predicted.

Cited by 28 publications

References 49 publications

Experimental models for posterior capsule opacification research

Experimental models for posterior capsule opacification research

In Vitro Growth of Lens Epithelial Cells from Cataract Patients - Association with Possible Risk Factors for Posterior Capsule Opacification

Short-term effect of nd:yag laser capsulotomy on refraction, central macular thickness and retinal nerve fber layer thickness

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