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M. Pollhammer, C. Cursiefen, C. Rummelt, R. Walker, R. Thyzel, F. E. Kruse; In vivo Ablation of Lens Epithelial Cells in Rabbit Eyes With the ARC-Laser-Photolysis-System to Prevent Posterior Capsule Opacification. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5475.
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In recent in-situ experiments using enucleated porcine eyes we demonstrated, that the ARC-Laser-Photolysis-System (ARC-LPS) allows a nearly complete ablation of lens epithelial cells from the lens capsule in the context of cataract surgery. The aim of this study was to evaluate the ARC-LPS in an in-vivo setting to develop a method to prevent posterior capsule opacification.
12 New Zealand White rabbits underwent standard cataract surgery on both eyes and were divided into a treatment- (laser ablation) and a control-group. Before injecting a foldable lens into the capsular bag, the hand piece of the ARC-LPS was inserted into the capsular bag of the treatment-group and a medium of 204 (±36) pulses with energy of 4mJ were applied onto the anterior and equatorial lens capsule in a meander like pattern.Postoperatively, a topical therapy with antibiotic and steroid eye drops was administered. Eyes were enucleated after six weeks and evaluated by histology. Digital images from a posterior Miyake/Apple view were taken and planimetry was performed using the EPCO-software system.
Evaluation of the digital images showed a significant reduction of posterior capsule opacification in eyes of the treatment group compared to eyes of the control group. EPCO-scores were 0.33 and 0.69 respectively (p=0.035). Capsule polishing was safely performed in all parts of the capsule even in areas where visibility was limited. In 2 of 8 eyes a small bleeding was observed originating from iris vessels.
Laser ablation with the ARC-LPS as a new surgical technique for PCO-prevention leads to a significant reduction of PCO-formation after 6 weeks. Complications like bleeding from iris vessels can be minimized by reduction of laser energy, so that this system could easily be used during human cataract surgery to prevent posterior capsule opacification. Currently, this device is already used to fragment the nucleus during laser-phaco.
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