Abstract
Purpose :
Stable positioning of an intraocular lens (IOL) in the capsular bag following cataract surgery is important for successful visual outcomes. Wound-healing events modify the capsular bag and can affect IOL stability. We therefore conducted a study to assess IOL/capsular bag interactions in a human in vitro capsular bag model over a three-month experimental period.
Methods :
Capsulorhexis and lens extraction performed on human donor eyes generated suspended capsular bags (5 match-paired experiments). Preparations were secured by pinning the ciliary body to a silicone ring and maintained in 6 mL of medium for 84 days: days 1–3, 5% human serum and 10 ng/mL transforming growth factor β (TGFβ2); days 4–7, 2% human serum and 1 ng/mL TGFβ2; days 8–14, 1% human serum and 0.1 ng/mL TGFβ2; days 15–84, serum-free EMEM. A CT LUCIA 611PY IOL was implanted in all preparations. Quantitative measures were determined from whole bag images captured weekly. Images were registered and analysed in ImageJ to determine capsular bag area; distortion; angle of contact; and a fusion footprint associated with connection between the anterior and posterior capsules.
Results :
Following surgery and IOL implantation, capsular bags appeared distorted, such that a long axis formed between the haptics relative to the non-haptic regions (short axis). The angle of contact between the haptics and the bag periphery inversely correlated to capsular bag area. Growth on the peripheral posterior capsule was observed 1 week after surgery and behind the IOL within 1 month. As coverage of the posterior capsule progressed matrix contraction/wrinkles were observed. Fusion footprints formed in non-haptic regions of the peripheral bag. Refractive structures formed in fusion footprint regions in the latter months of culture. Over time, the capsular bag area reduced, while the long/short axis ratio and angle of contact increased. End-point analysis revealed strong interaction between the CT LUCIA 611PY optic edge and the capsule. An indent in the posterior capsule was evident and cell density was greater peripheral to this mark.
Conclusions :
The three-month graded model presents features of fibrotic and regenerative posterior capsule opacification and allows IOL/capsular bag interactions to be quantified and compared over time. The CT LUCIA 611PY IOL is stable within the bag and exhibits a strong optic barrier effect.
This is a 2021 ARVO Annual Meeting abstract.