Abstract
BackgroundPosterior capsule opacification (PCO) after cataract surgery is influenced by intraocular lens (IOL) design and material. The following is an ex vivo comparison of PCO between the Clareon vs. the AcrySof IOL in human capsular bags.MethodsTwenty cadaver capsular bags from 10 human donors were used, with the novel hydrophobic IOL (Clareon, CNA0T0) being implanted in one eye and the other eye of the same donor receiving the AcrySof IOL (SN60WF) following phacoemulsification cataract surgery. Five capsular bags of 3 donors served as controls without IOL. Cellular growth of lens epithelial cells was photo-documented daily. The primary endpoint was the time until full coverage of the posterior capsule by cells. Furthermore, immunofluorescence staining of capsular bags for the fibrotic markers f-actin, fibronectin, alpha smooth muscle actin, and collagen type 1 were performed.ResultsThe new Clareon IOL did not show any disadvantages in terms of days until full cell coverage of the posterior capsule in comparison to the AcrySof (p > 0.99). Both, the Clareon (p = 0.01, 14.8 days) and the AcrySof IOL (p = 0.005, 15.7 days) showed a slower PCO development in comparison to the control (8.6 days). The fibrotic markers f-actin, fibronectin, alpha smooth muscle actin, and collagen type 1 were equally distributed between the two IOLs and differed from the control.ConclusionsA comparable performance has been found in the ex vivo formation of PCO between the two IOLs. Long-term clinical studies are necessary to reach final conclusions.
Highlights
Posterior capsule opacification (PCO) after cataract surgery is influenced by intraocular lens (IOL) design and material
Posterior capsule opacification (PCO) develops regularly after cataract surgery [1]. This unwanted wound healing reaction is thought to originate from lens epithelial cells that remain in the capsular bag after cataract surgery, especially on the inside of the anterior capsule and the capsular equator
Regarding the growth pattern, remaining lens epithelial cells started to grow from the capsule equator to the center of the IOL which, in vivo, represents the optical axis
Summary
Posterior capsule opacification (PCO) after cataract surgery is influenced by intraocular lens (IOL) design and material. Posterior capsule opacification (PCO) develops regularly after cataract surgery [1]. This unwanted wound healing reaction is thought to originate from lens epithelial cells that remain in the capsular bag after cataract surgery, especially on the inside of the anterior capsule and the capsular equator. After getting activated by several surgically and implant induced cytokines and growth-factors, cells undergo epithelial–mesenchymal transition to Recently the Clareon IOL (Alcon, Fort Worth, Texas, USA) was introduced. Its’ design is similar to the AcrySof IQ (Alcon, Fort Worth, Texas, USA), but the new material is made of a proprietary cross-linked acrylic optic biomaterial developed by combining a hydrophilic polymer (2hydroxyethyl-methacrylate) and a hydrophobic component. The IOL has a sharp optic edge, which is interrupted at the haptic optic junction and is made of a hydrophobic acrylic polymer mix (phenylethyl methacrylate, phenylethyl acrylate, butanediol diacrylate) [6]
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