Pathologic assessment of complications with asymmetric or sulcus fixation of square-edged hydrophobic acrylic intraocular lenses.
Ophthalmology
; 119(5): 907-13, 2012 May.
Article
en En
| MEDLINE
| ID: mdl-22424575
ABSTRACT
OBJECTIVE:
One-piece hydrophobic acrylic intraocular lenses (IOLs) are not indicated for sulcus fixation because of complications, such as uveitis-glaucoma-hyphema syndrome. Similar complications may also be observed with 3-piece lenses that have a square optic edge on the anterior surface. The objective of this study was to provide pathologic evidence of complications related to out-of-the-bag fixation of 1- or 3-piece hydrophobic acrylic IOLs with anterior and posterior square optic edges.DESIGN:
Comparative case series with pathology.PARTICIPANTS:
A total of 661 pseudophakic cadaver eyes obtained from eye banks within the United States, implanted with different IOLs.METHODS:
Anterior segment scanning of whole eyes with a high-frequency ultrasound system or high-resolution anterior segment magnetic resonance imaging, followed by gross examination. Selected eyes were processed for complete histopathologic analysis; some of them were explanted before histopathology to allow for direct light microscopic evaluation of the lenses. MAIN OUTCOMEMEASURES:
Findings from imaging, gross, and histopathologic evaluation that could be related to out-of-the-bag fixation of the lenses.RESULTS:
A total of 256 eyes were implanted with hydrophobic acrylic IOLs with anterior and posterior square optic edges; 18 of them exhibiting asymmetric or sulcus IOL fixation (six 1-piece and twelve 3-piece IOLs) underwent complete histopathologic evaluation and were compared with the contralateral eyes with symmetric in-the-bag IOL implantation. Pathologic findings were composed of IOL decentration and tilt, pigmentary dispersion within the anterior segment and on the IOL surface, iris transillumination defects, iris changes including vacuolization/disruption/loss of the pigmented layer, iris thinning, and iris atrophy, as well as synechiae and loop erosion in the case of 3-piece lenses. Findings were more significant in comparison with the control contralateral eyes and were particularly evident in relation to the sulcus-fixated haptic in the case of 1-piece lenses. The majority of the eyes with 3-piece lenses showed signs of complicated surgery.CONCLUSIONS:
This study provides pathologic correlation of complications that were clinically reported in the peer-reviewed literature in relation to sulcus fixation of 1-piece hydrophobic acrylic IOLs. The eyes with 3-piece lenses generally exhibited evidence of complicated surgery; therefore, all pathologic findings in those cases may not be strictly attributed to the out-of-the-bag fixation.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Resinas Acrílicas
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Implantación de Lentes Intraoculares
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Migracion de Implante de Lente Artificial
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Complicaciones Intraoperatorias
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Lentes Intraoculares
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
Límite:
Aged
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Aged80
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Humans
Idioma:
En
Revista:
Ophthalmology
Año:
2012
Tipo del documento:
Article
País de afiliación:
Estados Unidos