Infantile lensectomy and intraocular lens implantation with long-term follow-up in a monkey model.

Abstract

To report the long-term clinical and histopathologic findings in infant monkeys following a lensectomy and intraocular lens (IOL) implantation using two different surgical techniques. A lensectomy and IOL implantation was performed on the right eye of 10 infant monkeys. A posterior capsulotomy was performed using a limbal approach in 5 monkeys (Group 1), and a pars plana approach in 5 other monkeys (Group 2). The residual refractive error in the pseudophakic eye was then corrected with a contact lens and the fellow eye was occluded for 70% of the daylight hours. The monkeys were then examined at regular intervals for 2 to 4 years. Visual acuity was assessed using operant testing and sweep visual evoked potentials (VEPs). At the end of the study, the pseudophakic eyes were studied histopathologically. The only complications that required reoperation were diaphanous fibrin membranes on the lens optic (n=10) and lens reproliferation into the pupillary space (n=5). The visual outcome was similar in Groups 1 and 2, with better acuities in the phakic eyes compared with the pseudophakic eyes. A higher percentage of both haptics were found in the capsular bag for the monkeys in Group 2 (n=3) than in Group 1 (n=1). Although haptic placement was superior using a pars plana approach to perform the primary posterior capsulotomy, no clinically discernable difference was noted in IOL centration between the monkeys undergoing a limbal versus a pars plana posterior capsulotomy and no difference was noted in the visual outcome.