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Heparin-surface-modified intraocular lenses in pediatric cataract surgery: prospective randomized study
S Basti1, M K Aasuri, M K Reddy
1Cornea Service, Bausch & Lomb Contact Lens Centre, L.V. Prasad Eye Institute, Hyderabad, India.
Insights
Heparin-surface-modified (HSM) intraocular lenses (IOLs) significantly reduced inflammatory cell deposits in pediatric cataract surgery. These biocompatible IOLs show improved performance compared to unmodified IOLs in children.
Area of Science:
- Ophthalmology
- Biomaterials Science
- Pediatric Surgery
Background:
- Pediatric cataract surgery requires IOLs with excellent biocompatibility to minimize postoperative inflammation.
- Inflammatory responses can lead to complications like cell deposits and synechia formation, impacting visual outcomes.
- Heparin-surface modification (HSM) of IOLs is explored to enhance biocompatibility.
Purpose of the Study:
- To evaluate the clinical performance of heparin-surface-modified (HSM) poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) in pediatric eyes.
- To compare the incidence of inflammatory cell deposits, posterior synechias, and anterior chamber reactions between HSM and unmodified IOLs.
Main Methods:
- A prospective, randomized, double-masked, controlled trial involving 90 children (aged 2-14 years) with cataract.
- Patients received either an HSM PMMA IOL (Group 1) or an unmodified PMMA IOL (Group 2).
- Surgical techniques included extracapsular cataract extraction (ECCE) with IOL implantation, with modifications for younger children.
Main Results:
- Follow-up at 1 week, 1 month, 3 months, and 6 months included 73-68 patients.
- Group 1 (HSM IOLs) demonstrated significantly fewer inflammatory cell deposits at 1, 3, and 6 months (P < .001).
- Posterior synechia formation and anterior chamber reaction were comparable between the two groups.
Conclusions:
- HSM PMMA IOLs exhibit superior biocompatibility compared to unmodified IOLs in pediatric cataract surgery.
- The reduced inflammatory cell deposition suggests HSM IOLs are a promising option for pediatric patients.
- Further research may explore long-term outcomes and benefits of HSM IOLs in pediatric populations.
Purpose:
To evaluate the performance of heparin-surface-modified (HSM) intraocular lenses (IOLs) in pediatric eyes after cataract surgery.
Setting:
L.V. Prasad Eye Institute, Hyderabad, India.
Methods:
This prospective, randomized, double-masked, controlled clinical trial comprised 90 children aged 2 to 14 years with cataract. The patients were consecutively randomized to receive an HSM (Group 1) or an unmodified (Group 2) poly(methyl methacrylate) (PMMA) IOL. Extracapsular cataract extraction (ECCE) with IOL implantation was performed in children 8 years and older and ECCE with primary posterior capsulotomy, anterior vitrectomy, and IOL implantation in children younger than 8 years. Outcome parameters were inflammatory cell deposits on the IOL surface, posterior synechias, and anterior chamber reaction.
Results:
Follow-up data were available for 73, 70, 60, and 68 patients at 1 week, 1 month, 3 months, and 6 months, respectively. Significantly fewer cell deposits were noted in Group 1 at 1, 3, and 6 months (P < .001). Synechia formation and anterior chamber reaction were comparable in the 2 groups.
Conclusion:
The lower incidence of inflammatory cell deposit formation in eyes with HSM PMMA IOLs indicates that these IOLs have greater bicompatibility than unmodified IOLs in pediatric cataract surgery.