Lens Epithelial Cell Removal in Routine Phacoemulsification: Is It Worth the Bother?

Darian-Smith, Erica; Safran, Steven G.; Coroneo, Minas T.

doi:10.1016/j.ajo.2022.01.013

Cited by 10 publications

(11 citation statements)

References 62 publications

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“…Therefore, to minimize the possible effects of these factors, we chose one type of IOL for each group [ 20 , 21 ]. In addition, every attempt was also performed to reduce the incidence of after-cataract formation by performing atraumatic surgery with a continuous curvilinear capsulorhexis and a complete residual cortical cleanup after surgery with meticulous posterior capsule cleaning and “in-the-bag" implantation of the IOL in both groups [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Rate of Posterior Capsule Opacification Following Combined Treatment With Topical Dexamethasone 0.1% Plus Ketorolac 0.5% Eye Drops Versus Dexamethasone 0.1% Alone: A Two-Year, Randomized Clinical Investigation

Evereklioğlu¹,

Arda²,

Şener³

et al. 2023

Cureus

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Background and aimThe use of non-steroidal anti-inflammatory drugs in animals decreases the incidence of posterior capsular opacification (PCO) following cataract surgery. We evaluated the rate of PCO in patients with cataract surgery and foldable "in the bag" posterior chamber intraocular lens (PC-IOL) implantation treated with combined dexamethasone 0.1% plus ketorolac tromethamine 0.5% versus dexamethasone 0.1% alone. Materials and methodsA total of 114 eyes of 101 patients underwent uneventful corneal small-incision phacoemulsification with primary implantation of a foldable acrylic PC-IOL (AcrySof ® , Alcon, Fort Worth, USA). Postoperatively for four weeks, group 1 eyes were treated with dexamethasone 0.1% plus ketorolac tromethamine 0.5% ophthalmic solutions four times daily for each whereas group 2 eyes were treated with dexamethasone 0.1% alone. Other regiments were the same for each group. Patients were evaluated between one-and fouryear following surgery. The frequency and timing of severe PCO following surgery that needed Nd:YAG laser posterior capsulotomy were recorded and evaluated. ResultsThe mean (SEM) age of group 1 (n = 54) and group 2 (n = 60) at operation was similar (62.8 ± 2.2 vs. 60.6 ± 1.7 years, respectively). Eighty-eight patients had unilateral cataract and 13 cases had bilateral disease. Overall, the mean follow-up duration was 24.7 months postoperatively (range, 15-48). Clinically significant PCO that finally needed Nd:YAG laser application developed in two eyes (3.7%) in group 1 and in four eyes (6.6%) in group 2, and the difference was not statistically significant (p>0.05). The mean month at capsulotomy was 26.5 in group 1 and 24.3 months in group 2 eyes (p>0.05). ConclusionsTopical instillation of ketorolac ophthalmic solution in the immediate period after phacoemulsification and PC-IOL implantation did not seem to influence the incidence of PCO formation two years after cataract surgery.

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Section: Discussionmentioning

confidence: 99%

Comparison of the Rate of Posterior Capsule Opacification Following Combined Treatment With Topical Dexamethasone 0.1% Plus Ketorolac 0.5% Eye Drops Versus Dexamethasone 0.1% Alone: A Two-Year, Randomized Clinical Investigation

Evereklioğlu¹,

Arda²,

Şener³

et al. 2023

Cureus

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“…Anecdotally, in our clinical experience, where routine and fastidious LEC removal has occurred there have been no longer-term cases of dead bag syndrome develop. 4…”

Section: Dead Bag Syndrome: a Look At The Dystrophic Bagmentioning

confidence: 99%

“…Anecdotally, in our clinical experience, where routine and fastidious LEC removal has occurred there have been no longer-term cases of dead bag syndrome develop. 4 Another hypothesis for pathogenesis of dead bag syndrome involves fluoroquinolone antibiotic use and zonular MMP activation. Fluoroquinolone antibiotics have been used intracamerally for cataract surgery in the United States since 2003.…”

Section: Dead Bag Syndrome: a Look At The Dystrophic Bagmentioning

confidence: 99%

“…This arrangement has given us a distinct advantage over other implant procedures, in that given the relative tolerance and static nature of the avascular, aneuronal, and relatively inert capsular bag, we are not usually faced with host-implant interface issues (such as chronic inflammation) that bedevil other body part replacements. 4 However, with time and the increased longevity of implantees, the cloud of IOL subluxation has appeared on the horizon. First reported in 1993, it had been predicted by Jan Worst in approximately 1980.…”

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confidence: 99%

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Zonular and capsular bag disorders: a hypothetical perspective based on recent pathophysiological insights

Darian-Smith

Safran²,

Coroneo³

2023

J Cataract Refract Surg

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“…Several strategies, including surgical techniques, IOL materials, IOL with square edge design and drug-eluting IOL, were performed for the prophylaxis of PCO ( Awasthi et al, 2009 ; Topete et al, 2021 ; Liu et al, 2022a ; Lu et al, 2022 ). The introduction of the hydrophobic IOLs with a square edge design can reduce PCO incidence, but the efficacy is limited ( Leydolt et al, 2020 ; Maedel et al, 2021 ; Xiang et al, 2021 ; Darian-Smith et al, 2022 ). Recently, drug-loaded IOLs which contribute to suppressing the proliferation and migration of LECs have been an attractive strategy to prevent PCO ( Zhang and Xie, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Two-dimensional ultrathin Ti3C2 MXene nanosheets coated intraocular lens for synergistic photothermal and NIR-controllable rapamycin releasing therapy against posterior capsule opacification

Huang

et al. 2022

Front. Bioeng. Biotechnol.

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Posterior capsule opacification (PCO) is one of the most frequent late-onset complications after cataract surgery. Several kinds of drug-eluting intraocular lenses (IOL) were designed for sustainable drug release to suppress ocular inflammation, the proliferation of lens epithelial cells (LECs) and the development of PCO after cataract surgery. Despite previous advances in this field, the drug-loaded IOLs were limited in ocular toxicity, insufficient drug-loading capacity, and short release time. To prevent PCO and to address these drawbacks, a novel drug-loaded IOL (Rapa@Ti3C2-IOL), prepared from two-dimensional ultrathin Ti3C2 MXene nanosheets and rapamycin (Rapa), was fabricated with a two-step spin coating method in this study. Rapa@Ti3C2 was prepared via electrostatic self-assembly of Ti3C2 and Rapa, with a loading capacity of Rapa at 92%. Ti3C2 was used as a drug delivery reservoir of Rapa. Rapa@Ti3C2-IOL was designed to have the synergistic photothermal and near infrared (NIR)-controllable drug release property. As a result, Rapa@Ti3C2-IOL exhibited the advantages of simple preparation, high light transmittance, excellent photothermal conversion capacity, and NIR-controllable drug release behavior. The Rapa@Ti3C2 coating effectively eliminated the LECs around Rapa@Ti3C2-IOL under a mild 808-nm NIR laser irradiation (1.0 W/cm−2). Moreover, NIR-controllable Rapa release inhibited the migration of LECs and suppressed the inflammatory response after photothermal therapy in vitro. Then, Rapa@Ti3C2-IOL was implanted into chinchilla rabbit eyes, and the effectiveness and biocompatibility to prevent PCO were evaluated for 4 weeks. The Rapa@Ti3C2-IOL implant exhibited excellent PCO prevention ability with the assistance of NIR irradiation and no obvious pathological damage was observed in surrounding healthy tissues. In summary, the present study offers a promising strategy for preventing PCO via ultrathin Ti3C2 MXene nanosheet-based IOLs with synergistic photothermal and NIR-controllable Rapa release properties.

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Lens Epithelial Cell Removal in Routine Phacoemulsification: Is It Worth the Bother?

Cited by 10 publications

References 62 publications

Comparison of the Rate of Posterior Capsule Opacification Following Combined Treatment With Topical Dexamethasone 0.1% Plus Ketorolac 0.5% Eye Drops Versus Dexamethasone 0.1% Alone: A Two-Year, Randomized Clinical Investigation

Comparison of the Rate of Posterior Capsule Opacification Following Combined Treatment With Topical Dexamethasone 0.1% Plus Ketorolac 0.5% Eye Drops Versus Dexamethasone 0.1% Alone: A Two-Year, Randomized Clinical Investigation

Zonular and capsular bag disorders: a hypothetical perspective based on recent pathophysiological insights

Two-dimensional ultrathin Ti3C2 MXene nanosheets coated intraocular lens for synergistic photothermal and NIR-controllable rapamycin releasing therapy against posterior capsule opacification

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