Long-term results of sealed capsule irrigation using distilled water to prevent posterior capsule opacification: a prospective clinical randomised trial

Rabsilber, Tanja M.; Limberger, Il-Joo; Reuland, A. J.; Holzer, MP; Auffarth, Gerd U.

doi:10.1136/bjo.2006.106468

Cited by 39 publications

(43 citation statements)

References 28 publications

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“…The substance that initially was intended to be used, DDW, was ineffective in humans or rabbits. 3,9 Mitomycin C or 5-FU has been reported to inhibit the proliferation of LECs and prevent PCO. 3,6 However, the use of these agents may be toxic to the ocular tissues.…”

Section: Discussionmentioning

confidence: 99%

“…The capsular bag then was flushed with distilled deionized water (DDW), and afterwards a hydrophilic intraocular lens (IOL) was implanted. Irrigation with DDW, however, did not prevent the development of PCO either in humans 9 or rabbits. 3 We observed a beneficial effect in preventing PCO when the sealed system was irrigated with 5-fluorouracil (5-FU) 50 mg/ml in an animal model.…”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5][6] The sealed-capsule irrigation device (SCI) Perfect Capsule 7,8 (Milvella Ltd, Epping, Australia) was reported to be highly efficacious in sealing the capsular bag from the adjacent ocular structures in rabbit eyes. 3 In humans, Rabsilber et al, 9 reported that the device was safe when used after phacoemulsification. The capsular bag then was flushed with distilled deionized water (DDW), and afterwards a hydrophilic intraocular lens (IOL) was implanted.…”

Section: Introductionmentioning

confidence: 99%

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Transmission electron microscopy of the rabbit posterior capsule irrigated with thapsigargin and 5-fluorouracil in a sealed-capsule irrigation device

Abdelwahab

Lindell

Hultenby

et al. 2008

Eye

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Purpose To investigate, by transmission electron microscopy (TEM), the effect on the posterior capsule of a young rabbit eye of 5-fluorouracil (5-FU) or thapsigargin in a sealed-capsule irrigation device. Setting St Erik's Eye Hospital, Stockholm, Sweden. Methods Clear lens extraction was performed unilaterally in eight 4-week-old rabbits. A sealed-capsule irrigation device was irrigated for 2 min with 20 ml of one of the following: balanced salt solution (BSS; n ¼ 2), thapsigargin 300 lM (n ¼ 2), 5-FU 50 mg/ml (n ¼ 2), or 5-FU 25 mg/ml (n ¼ 2). The substances were washed out for 10 s with BSS. The eyes were left aphakic. Six weeks postoperatively, the animals were killed, and the posterior capsule was extracted and fixed for TEM. As a control, we also evaluated the capsules from the two fellow eyes in the BSS group that did not undergo surgery. Results The ultrastructure of the posterior capsule in eyes irrigated with 5-FU or thapsigargin did not differ from that in the eyes irrigated with BSS or in the eyes that did not have surgery. The membranes had the same ultrastructure with thin collagen fibres on the anterior and posterior face of the posterior capsule and an amorphic matrix. Conclusion Thapsigargin or 5-FU used in a sealed-capsule irrigation device does not seem to harm the posterior capsule, which appeared similar to when the capsule is irrigated with BSS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transmission electron microscopy of the rabbit posterior capsule irrigated with thapsigargin and 5-fluorouracil in a sealed-capsule irrigation device

Abdelwahab

Lindell

Hultenby

et al. 2008

Eye

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“…and monkeys [47,48] . Furthermore, different methods for drug application were tested [26,33,34,36,47,49] . Irrespective of the drug application, the effective local drug concentration must have been adequate to reduce the LEC viability to result in a long-term decrease in PCO.…”

Section: Discussionmentioning

confidence: 99%

Drug-Induced Secondary Cataract Prevention: Experimental ex vivo and in vivo Results with Disulfiram, Methotrexate and Actinomycin D

et al. 2010

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Background/Aims: A clinical approach to prevent secondary cataract after lens implantation involves the intraocular application of pharmacological agents. The goals of our study were to develop an ex vivo model to test the drug effectiveness for lens epithelial cell ablation from the basal membrane and to verify the data in rabbit intraocular lens implantation experiments. Methods: Human capsular rhexis specimens were incubated with drugs and the residual cells were differentiated by use of the Live-Dead assay and quantified by staining with Hoechst dye. After phakoemulsification of rabbit eyes and before intraocular lens implantation, capsular bags were filled with drug-loaded hyaluronic acid for 5 min. Results: An ex vivo model was established which allows the testing of drugs on lens epithelial cell ablation. Drug treatment reduced the number of viable cells on the specimens drastically, ranging between 0.44 ± 0.53% (6.0 ± 7.3 cells/mm²) for disulfiram, 0.27 ± 0.50% (3.7 ± 6.9 cells/mm²) for methotrexate and 0.07 ± 0.19% (0.1 ± 0.27 cells/mm²) for actinomycin D. Rabbit eyes treated with a mixture of methotrexate/actinomycin D showed no posterior capsule opacification at 4 months and a low opacification 6 months postoperatively. Without drug treatment low opacification starts 6 weeks postoperatively. Conclusions: The drug screening in the described ex vivo model can help to reduce the number of preclinical studies for secondary cataract prevention. The successful ex vivo cell ablation by methotrexate/actinomycin D was confirmed by a delayed in vivo secondary cataract formation.

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“…However, a recent study of human adults found that irrigation with distilled deionized water had no effect on PCO. 11 We previously found that 5-fluorouracil (5-FU) 50 mg/ml effectively killed LECs in a rabbit model. 12 We also showed that it is safe to use 5-FU with the device.…”

Section: Introductionmentioning

confidence: 99%

Irrigation with thapsigargin and various concentrations of 5-fluorouracil in a sealed-capsule irrigation device in young rabbit eyes to prevent after-cataract

Abdelwahab

Kugelberg

Zetterström

2008

Eye

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Aim To investigate the effect on after-cataract and synechiae formation after clear lens extraction and irrigation with different substances in a sealed-capsule irrigation device. Setting St Erik's Eye Hospital, Stockholm, Sweden. Methods Clear lens extraction was performed in one eye of 42 4-week-old rabbits. The sealed-capsule irrigation device was applied and the sealed system was irrigated for 2 min with 20 ml of one of four substances: balanced salt solution (BSS), thapsigargin, 5-fluorouracil (5-FU) 50 mg/ml, or 5-FU 25 mg/ml. The substance then was washed out for 10 s with BSS. The eyes were left aphakic. Formation of after-cataract and synechiae was evaluated during two clinical examinations 3.5 and 5.5 weeks postoperatively, by photographs 5 weeks postoperatively, and by histologic evaluation of haematoxylin-eosin-stained slides after the 6-week end point postoperatively. After-cataract and synechiae were graded on a scale from 0 to 4. KruskalWallis analysis of variance with multiple comparisons was used for statistical analyses.Results 5-FU 50 mg/ml prevented aftercataract and synechiae formation best when compared with all other substances at all evaluations. 5-FU 25 mg/ml was not as effective, and thapsigargin was ineffective in this animal model.Conclusion 5-FU 50 mg/ml used in the sealedcapsule irrigation device satisfactorily prevents after-cataract and synechiae. Thapsigargin was ineffective in this animal model.

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Long-term results of sealed capsule irrigation using distilled water to prevent posterior capsule opacification: a prospective clinical randomised trial

Cited by 39 publications

References 28 publications

Transmission electron microscopy of the rabbit posterior capsule irrigated with thapsigargin and 5-fluorouracil in a sealed-capsule irrigation device

Transmission electron microscopy of the rabbit posterior capsule irrigated with thapsigargin and 5-fluorouracil in a sealed-capsule irrigation device

Drug-Induced Secondary Cataract Prevention: Experimental ex vivo and in vivo Results with Disulfiram, Methotrexate and Actinomycin D

Irrigation with thapsigargin and various concentrations of 5-fluorouracil in a sealed-capsule irrigation device in young rabbit eyes to prevent after-cataract

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