Capsular Outcomes After Pediatric Cataract Surgery Without Intraocular Lens Implantation

Tan, Xuhua; Lin, Haotian; Lin, Zhuoling; Chen, Jingjing; Tang, Xiaoyong; Luo, Lixia; Chen, Weirong; Liu, Yizhi

doi:10.1097/md.0000000000002993

Cited by 5 publications

(7 citation statements)

References 26 publications

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“…In a previous study, COD was measured with a self-made measuring needle with a laser marker (1 mm scale) (12). This Detailed change in capsulotomy opening diameter (COD) between the two surgeries.…”

Section: Discussionmentioning

confidence: 99%

Capsulotomy opening diameter outcomes in aphakic eyes after primary congenital cataract removal and its association

Zhao

Zhao²,

Wang³

et al. 2023

Front. Pediatr.

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AimTo observe the change of capsulotomy opening diameter (COD) in aphakic eyes after primary congenital cataract removal and investigate its influencing factors.MethodsOcular parameters, including corneal diameter (CD), axial length (AL), anterior and posterior COD (ACOD, PCOD), and age at surgery were recorded at primary congenital cataract removal and secondary intraocular lens implantation. The concentrations of 15 kinds of cytokines in aqueous humor samples collected at the primary surgery were detected. The change (Δ) of COD between two surgeries were described, and its association was analyzed.ResultsFifty eyes from 33 patients with congenital cataract who underwent primary and secondary surgery were enrolled. The changes in ACOD and PCOD were not statistically significant on the whole. ΔACOD was positively correlated with ΔCD and the concentrations of PDGF-AA, VEGF and TGF-β1. The concentration of FGF-2 and the interval between two surgeries showed negative correlations with ΔACOD and ΔPCOD.ConclusionCOD in aphakic eyes kept changing after primary surgery. The positive correlation between ΔACOD and ΔCD manifested the enlargement of ACOD was influenced by lateral eye growth. Meanwhile, ΔACOD was also associated with cytokines, indicating postoperative inflammation promoted the ACOD constriction.

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Section: Discussionmentioning

confidence: 99%

Capsulotomy opening diameter outcomes in aphakic eyes after primary congenital cataract removal and its association

Zhao

Zhao²,

Wang³

et al. 2023

Front. Pediatr.

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“…The diameter of the anterior capsular opening was about 5.0-5.5 mm, and the posterior capsular opening was about 3.0-4.5 mm. The anterior and posterior vitrectorhexis or capsulorhexis diameters were controlled using a spatula with laser markers (1-mm scale) (9). Then, a posterior chamber IOL was inserted into the capsular bag -8 eyes with AcrySof SA60AT (Alcon, Fort Worth, TX, United States); 16 eyes with Tecnis ZCB00 (AMO, Santa Ana, CA, United States); and 3 eyes with A1-UV (Eyebright, Beijing, China) (10,11).…”

Section: Surgerymentioning

confidence: 99%

“…Due to the difficulty of its examination in children, few studies have focused on the capsular outcomes of pediatric cataract surgery. Studies by Lin et al (8) and Tan et al (9) found that the anterior capsular opening (ACO) contracted, and the posterior capsular opening expanded after pediatric cataract surgery without IOL implantation. However, changes in the capsular outcomes in the pediatric cataract extraction with in-the-bag IOL implantation remain unknown.…”

Section: Introductionmentioning

confidence: 99%

Posterior Capsular Outcomes of Pediatric Cataract Surgery With In-The-Bag Intraocular Lens Implantation

Wang

Ding

et al. 2022

Front. Pediatr.

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AimTo investigate the change of posterior capsular outcomes of pediatric cataract surgery with primary in-the-bag intraocular lens (IOL) implantation.MethodsWe conducted a case series of pediatric cataract children who underwent cataract extraction with primary in-the-bag IOL implantation, posterior capsulorhexis or vitrectorhexis, and limited anterior vitrectomy at the Eye Hospital of Wenzhou Medical University between 2016 and 2019. Digital retro-illumination photographs of pediatric eyes were obtained at baseline and 6 months, 12 months, and the last visit postoperatively. Capsular outcomes of the posterior capsular opening area (PCOA) and lens reprolifration area at those time points were compared. Correlations between the PCOA and influential factors, such as age at surgery, axial growth, and follow-up duration, were analyzed. The study was registered at register.clinicaltrials.gov (NCT04803097).ResultsData of 23 patients (27 eyes) were used in the final analysis. During follow-up, the PCOA enlarged at a rate of 0.29–0.32 mm2/month during the first six months postoperatively and 0.05–0.08 mm2/month over the next 1–2 years. Six months postoperatively, the PCOA enlargement statistically and positively correlated with the follow-up duration and axial growth. The area of lens reprolifration was 0.46 ± 1.00 mm2 at six months postoperatively and then remained stable.ConclusionThe PCOA enlarged rapidly within the first six months after the pediatric cataract surgery with primary IOL implantation. Six months postoperatively, the enlargement of PCOA was positively correlated with follow-up duration and axial growth. Posterior capsulorhexis or capsulectomy should be performed with a diameter of 3.0 to 4.0 mm for good visual axis transparency and the protection of in-the-bag IOL.

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“…The shape of the regenerated lens depends on the integrity and closure of the lens capsule, and the adhesion between the lens anterior and posterior capsules (36,37). Previous studies showed that there were different amounts of fibrin at the incision of lens capsule, which could seal the capsule with scar.…”

Section: Capsulorhexis Size and Integrity Of The Lens Capsulementioning

confidence: 99%

Lens regeneration in humans: using regenerative potential for tissue repairing

2020

Self Cite

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The crystalline lens is an important optic element in human eyes. It is transparent and biconvex, refracting light and accommodating to form a clear retinal image. The lens originates from the embryonic ectoderm. The epithelial cells at the lens equator proliferate, elongate and differentiate into highly aligned lens fiber cells, which are the structural basis for maintaining the transparency of the lens. Cataract refers to the opacity of the lens. Currently, the treatment of cataract is to remove the opaque lens and implant an intraocular lens (IOL). This strategy is inappropriate for children younger than 2 years, because a developing eyeball is prone to have severe complications such as inflammatory proliferation and secondary glaucoma.On the other hand, the absence of the crystalline lens greatly affects visual function rehabilitation. The researchers found that mammalian lenses possess regenerative potential. We identified lens stem cells through linear tracking experiments and designed a minimally invasive lens-content removal surgery (MILS) to remove the opaque lens material while preserving the lens capsule, stem cells and microenvironment. In infants with congenital cataract, functional lens regeneration in situ can be observed after MILS, and the prognosis of visual function is better than that of traditional surgery. Because of insufficient regenerative ability in humans, the morphology and volume of the regenerated lens cannot reach the level of a normal lens. The activation, proliferation and differentiation of lens stem cells and the alignment of lens fibers are regulated by epigenetic factors, growth factors, transcription factors, immune system and other signals and their interactions. The construction of appropriate microenvironment can accelerate lens regeneration and improve its morphology. The therapeutic concept of MILS combined with microenvironment manipulation to activate endogenous stem cells for functional regeneration of organs in situ can be extended to other tissues and organs with strong self-renewal and repair ability.

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Capsular Outcomes After Pediatric Cataract Surgery Without Intraocular Lens Implantation

Cited by 5 publications

References 26 publications

Capsulotomy opening diameter outcomes in aphakic eyes after primary congenital cataract removal and its association

Capsulotomy opening diameter outcomes in aphakic eyes after primary congenital cataract removal and its association

Posterior Capsular Outcomes of Pediatric Cataract Surgery With In-The-Bag Intraocular Lens Implantation

Lens regeneration in humans: using regenerative potential for tissue repairing

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