Long-Term Uveal and Capsular Biocompatibility and Stability of New Disc-Shaped IOL After Nd:YAG Posterior Capsulotomy

Ford, Joshua

Long-Term Uveal and Capsular Biocompatibility and Stability of New Disc-Shaped IOL After Nd:YAG Posterior Capsulotomy

Monday, April 28, 2014: 4:04 PM

Room 155 (Boston Convention and Exhibition Center)

Joshua R. Ford, MD, Moran Eye Center, University of Utah, Salt Lake City, UT, USA

Justin Kohl, MD, University of Utah, Salt Lake City, UT, USA

Scott C. Cole, MD, John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA

Gareth Gardiner, BS, John A. Moran Eye Center, Salt Lake City, UT, USA

Shail A. Vasavada, MD, John A. Moran Eye Center, Salt Lake City, UT, USA

Liliana Werner, MD, PhD, John A. Moran Eye Center, Salt Lake City, UT, USA

Nick Mamalis, MD, Moran Eye Ctr/Univ of Utah, Salt Lake City, Utah, USA

Narrative Responses:

Purpose
To evaluate long-term uveal biocompatibility, capsular bag opacification, and stability after Nd:YAG laser capsulotomy, of a new single-piece, hydrophilic acrylic intraocular lens (IOL) suspended between two complete haptic rings connected by pillars of the haptic material.

Methods
Study IOLs were implanted into the right eyes of 8 New Zealand white rabbits; the left eye received a commercially available single-piece hydrophobic acrylic lens. Slit lamp examinations were performed at weeks 1, 2, 4, 6, and 8, and then at months 3 and 6, followed by sacrifice, enucleation, gross examination and histopathology. In a study subset, study lenses were implanted bilaterally in 5 other rabbits. Nd:YAG posterior capsulotomy was performed on the right eyes at 4 weeks postoperatively. Two weeks later, all eyes were enucleated and underwent anterior segment optical coherence tomography (AS-OCT), gross and histopathologic examination.

Results
The 6-month examinations were completed for the 8 rabbits in the long-term study, revealing similar uveal biocompatibility but a significant advantage of the study lens over the control lens in terms of capsular opacification. Central posterior capsule opacification (PCO) was 0.71 +/- 0.26 in the study group and 4 +/- 0 in the control group (P < 0.0001). In the study subset, slit-lamp examination, AS-OCT analysis, and gross and histopathologic analyses showed excellent centration and stability of the study lenses within the capsular bag following Nd:YAG capsulotomy, no evidence of inflammation or toxicity in the eyes, and clear anterior and peripheral posterior capsules.

Conclusion
The new disc-shaped IOL has shown similar uveal biocompatibility to the control lens. The peripheral rings of the study IOL, by expanding the capsular bag and preventing contact with the anterior capsule, appear to prevent opacification of the capsular bag. The lens was also stable after Nd:YAG posterior capsulotomy.