Intraocular lens optic edge design for the prevention of posterior capsule opacification after cataract surgery

Maedel, Sophie; Evans, Jennifer R; Harrer-Seely, Annette; Findl, Oliver

doi:10.1002/14651858.cd012516.pub2

Cited by 24 publications

(20 citation statements)

References 90 publications

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“…PCO has been linked to patient factors, cataract surgical techniques and implanted intra-ocular lens (IOL) materials or design, such as the established reduction in PCO rates seen with square-edged IOL designs compared to round edge IOL shown by systematic review of randomised controlled trials (RCT). (1,2).…”

Section: Introductionmentioning

confidence: 99%

The Royal College of Ophthalmologists’ National Ophthalmology Database study of cataract surgery: Report 9, Risk factors for posterior capsule opacification

Donachie

Barnes

Olaitan

et al. 2022

Eye

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What was known before:-Posterior Capsule Opacification (PCO) is the most common long-term postoperative adverse occurrence after cataract surgery -Factors associated with increased risk of PCO can relate to the patient or their eye, the surgery, or the intra-ocular lens (IOL) material and design, such as the well-established superiority of a square-edged IOL in preventing PCO What this study adds:-This is the largest published series investigating risk factors for PCO -The six month, one, three, five and nine year observed rates of PCO were 2.1%, 4.0%, 18.0%, 31.2% and 43.5% respectively -Risk factors that increased the risk of developing PCO included hydrophilic IOL material, an axial length >26 mm, high myopia, previous vitrectomy, uveitis/synechiae, younger age and female gender

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Section: Introductionmentioning

confidence: 99%

The Royal College of Ophthalmologists’ National Ophthalmology Database study of cataract surgery: Report 9, Risk factors for posterior capsule opacification

Donachie

Barnes

Olaitan

et al. 2022

Eye

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“…Importantly, with the increasing application of multifunctional IOL, such as multifocal IOL and astigmatism corrected IOL, people have higher expectations for visual quality, and PCO increases postoperative complaints related to visual quality ( Alio et al, 2017 ). Neodymium-doped yttrium aluminum garnet (Nd: YAG) laser has been regarded as the most effective therapeutic strategy for PCO till now ( Maedel et al, 2021 ), while a number of potential risks are inevitable, such as IOL dislocation, mild anterior uveitis, macular edema and retinal detachment ( Burq and Taqui, 2008 ). In addition, it is often inappropriate for children who are difficult to cooperate in the treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Several strategies, including surgical techniques, IOL materials, IOL with square edge design and drug-eluting IOL, were performed for the prophylaxis of PCO ( Awasthi et al, 2009 ; Topete et al, 2021 ; Liu et al, 2022a ; Lu et al, 2022 ). The introduction of the hydrophobic IOLs with a square edge design can reduce PCO incidence, but the efficacy is limited ( Leydolt et al, 2020 ; Maedel et al, 2021 ; Xiang et al, 2021 ; Darian-Smith et al, 2022 ). Recently, drug-loaded IOLs which contribute to suppressing the proliferation and migration of LECs have been an attractive strategy to prevent PCO ( Zhang and Xie, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Two-dimensional ultrathin Ti3C2 MXene nanosheets coated intraocular lens for synergistic photothermal and NIR-controllable rapamycin releasing therapy against posterior capsule opacification

Huang

et al. 2022

Front. Bioeng. Biotechnol.

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Posterior capsule opacification (PCO) is one of the most frequent late-onset complications after cataract surgery. Several kinds of drug-eluting intraocular lenses (IOL) were designed for sustainable drug release to suppress ocular inflammation, the proliferation of lens epithelial cells (LECs) and the development of PCO after cataract surgery. Despite previous advances in this field, the drug-loaded IOLs were limited in ocular toxicity, insufficient drug-loading capacity, and short release time. To prevent PCO and to address these drawbacks, a novel drug-loaded IOL (Rapa@Ti3C2-IOL), prepared from two-dimensional ultrathin Ti3C2 MXene nanosheets and rapamycin (Rapa), was fabricated with a two-step spin coating method in this study. Rapa@Ti3C2 was prepared via electrostatic self-assembly of Ti3C2 and Rapa, with a loading capacity of Rapa at 92%. Ti3C2 was used as a drug delivery reservoir of Rapa. Rapa@Ti3C2-IOL was designed to have the synergistic photothermal and near infrared (NIR)-controllable drug release property. As a result, Rapa@Ti3C2-IOL exhibited the advantages of simple preparation, high light transmittance, excellent photothermal conversion capacity, and NIR-controllable drug release behavior. The Rapa@Ti3C2 coating effectively eliminated the LECs around Rapa@Ti3C2-IOL under a mild 808-nm NIR laser irradiation (1.0 W/cm−2). Moreover, NIR-controllable Rapa release inhibited the migration of LECs and suppressed the inflammatory response after photothermal therapy in vitro. Then, Rapa@Ti3C2-IOL was implanted into chinchilla rabbit eyes, and the effectiveness and biocompatibility to prevent PCO were evaluated for 4 weeks. The Rapa@Ti3C2-IOL implant exhibited excellent PCO prevention ability with the assistance of NIR irradiation and no obvious pathological damage was observed in surrounding healthy tissues. In summary, the present study offers a promising strategy for preventing PCO via ultrathin Ti3C2 MXene nanosheet-based IOLs with synergistic photothermal and NIR-controllable Rapa release properties.

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“…5 While safe and effective, 6 the cataract surgery may cause posterior capsule opacification (PCO), which can lead to impaired contrast sensitivity, glare disabilities and reduced visual acuity. 7 , 8 PCO is treated with neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy. 7 This treatment, in turn, can be associated with further complications, including cystoid macular oedema (CME), late onset endophthalmitis, posterior vitreous detachment, reduction in vision, retinal detachment (RD), or uveitis, 9–11 all of which affect patients’ function of vision and quality of life.…”

Section: Introductionmentioning

confidence: 99%

Costs and Healthcare Resource Utilization Associated with Posterior Capsule Opacification After Cataract Surgery with Five Different Intraocular Lenses: An Economic Analysis for Spain

Belda

Placeres

Elvira

et al. 2022

OPTH

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Purpose To estimate the economic impact of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy and its related complications for five different intraocular lenses (IOLs) from the payer and hospital perspectives in Spain. Materials and Methods The three-year incidence rates of Nd:YAG laser capsulotomy after cataract surgery with five different single-piece acrylic monofocal IOLs (AcrySof IOLs, AJL LLASY60, IOL Tech Stabibag, Medicontur Bi-flex, Zeiss Asphina) for 8293 patients were derived from odds ratios of multivariate analysis adjusted for age, gender, and diabetic retinopathy. A cost-consequence model for a hypothetical cohort of 2000 eyes was then developed to quantify the potential impact of Nd:YAG capsulotomy in terms of costs and time for each of the included IOLs, from the payer and hospital perspectives. Results The adjusted three-year Nd:YAG laser capsulotomy incidence was 5.0% (95% CI 3.9 to 6.1) for AcrySof and ranged from 26.0% to 44.0% for the other four IOLs. The average costs of Nd:YAG treatment and related complications were €261.90 for payers and €19.99 for hospitals. The average time needed for Nd:YAG treatment and related complications was 32.82 minutes. Model estimates based on 2000 hypothetical cataract surgeries showed that AcrySof IOLs could lead to cost savings between €110,259.90 and €205,591.50 for payers. For hospitals, time, and cost savings with AcrySof ranged from 230.29 hours and €8415.79 compared to Zeiss Asphina to 429.40 hours and €15,692.15 compared to AJL LLASY60 IOLs. Conclusion Post cataract surgery, AcrySof IOLs were associated with a significantly lower incidence of Nd:YAG treatment and its subsequent complications compared to other IOLs. Our analysis shows that IOL choice is an important factor that can reduce the burden for patients, payers, and hospitals.

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Intraocular lens optic edge design for the prevention of posterior capsule opacification after cataract surgery

Abstract: Intraocular lens optic edge design for the prevention of posterior capsule opacification a er cataract surgery.

Cited by 24 publications

References 90 publications

The Royal College of Ophthalmologists’ National Ophthalmology Database study of cataract surgery: Report 9, Risk factors for posterior capsule opacification

The Royal College of Ophthalmologists’ National Ophthalmology Database study of cataract surgery: Report 9, Risk factors for posterior capsule opacification

Two-dimensional ultrathin Ti3C2 MXene nanosheets coated intraocular lens for synergistic photothermal and NIR-controllable rapamycin releasing therapy against posterior capsule opacification

Costs and Healthcare Resource Utilization Associated with Posterior Capsule Opacification After Cataract Surgery with Five Different Intraocular Lenses: An Economic Analysis for Spain

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