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Yinying Zhao, Jin Li, Weilin Lu, Xiaoying Xing, Fan Lu, Yune Zhao; Capsular Adhesion to Intraocular Lens Evaluated In Vivo Using Ultralong-scan-depth Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2013;54(15):829. doi: https://doi.org/.
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A firm capsular apposition to the intraocular lens (IOL) could inhibit lens epithelial cell proliferation and migration. Many researchers have focused on the design and material of the IOL. However, we found few studies evaluating the capsule-IOL interaction in highly myopic eyes. This study was to evaluate the in vivo capsular apposition to IOL in patients by ultralong-scan-depth optical coherence tomography (OCT).
It is an observational case series research. Thirty eyes from 30 cataract patients were recruited at the Affiliated Eye Hospital, Wenzhou Medical College, of which 15 eyes were highly myopic (axial length >26 mm) and 15 eyes were emmetropic (22 mm<axial length <24.5 mm). All eyes were examined with a custom-built ultralong-scan-depth OCT at 4hours, 1 month, 3 month, 1 year after surgery, as well as slit lamp examination.
Most of posterior capsule started to adhere with the IOL sectionally at 1 month after surgery. Complete apposition of the posterior capsule with the IOL was significantly less among highly myopic eyes than in emmetropic eyes at 1 year after surgery ( 10 vs 15 eyes; P<0.01). At 1-year follow-up, there are still 5 high myopia eyes with uncompleted apposition of the posterior capsule with the IOL. Posterior capsule adhesion to the IOL was inversely correlated with axial length (r=0.491, P<0.001, nonparametric Spearman test). The 6 types of adhesive capsular bend configurations observed were classified as anterior adhesion, middle adhesion, and posterior adhesion, funnel adhesion, parallel adhesion, and furcated adhesion during the follow-up. Seven highly myopic eyes had PCO at the 1-year follow-up, as did one emmetropic eye. Four of the eyes with PCO presented opened capsular bends and uncompleted apposition of the posterior capsule with the IOL, accompanied with proliferative lens epithelial cells observed by ultralong-scan-depth OCT. While the other three are presented closed capsular bends.
Ultralong-scan-depth OCT could be used to evaluate capsular adhesion and different types of capsular bend of eyes. Postoperatively, we found weak posterior capsule adhesion to the IOL in myopic eyes, as well as various types of capsular bending. These 2 weaknesses in the defense of highly myopic eyes could increase the incidence of PCO. These features presumably increase the likelihood of PCO during the early postoperative period.
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