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Extracapsular cataract extraction and pseudophakos implantation in primates: a clinico-pathologic study
Transactions of the American Ophthalmological Society
|January 1, 1980
Summary
This study compared three intraocular lens types in rhesus monkeys, finding all well-tolerated with minimal inflammation. Posterior capsule opacification was linked to lens epithelial cell metaplasia.
Area of Science:
- Ophthalmology
- Veterinary Medicine
- Biomaterials Science
Background:
- Cataract surgery often involves intraocular lens (IOL) implantation.
- Understanding the long-term histological effects of different IOL designs is crucial for patient outcomes.
- Previous studies have shown varying degrees of biocompatibility and tissue response to different IOLs.
Purpose of the Study:
- To histologically and clinically compare the long-term effects of three different intraocular lens designs in a primate model.
- To evaluate the tissue response and potential complications associated with Choyce Mark VIII, Binkhorst iridocapsular, and Shearing posterior chamber lenses.
- To investigate the mechanisms of posterior capsule opacification and iris-related complications following IOL implantation.
Main Methods:
- Eighteen Rhesus monkeys received either Choyce Mark VIII, Binkhorst, or Shearing IOLs.
- Eyes were examined clinically and histologically 4 to 28 months post-surgery.
- Control eyes included unoperated eyes and those with lens extraction only.
Main Results:
- All implants were clinically well-tolerated with minimal histological inflammation.
- Late posterior capsule opacification was attributed to lens epithelial cell metaplasia when exposed to aqueous humor.
- Binkhorst lenses showed mild iris pigment epithelium loss; Choyce lenses caused iris root changes; Shearing lens loops could erode the ciliary body if misplaced.
- Fibrous synechiae formation was associated with the absence of the anterior lens capsule.
Conclusions:
- Intraocular lens implantation, in general, showed good biocompatibility in this primate model.
- Posterior capsule opacification is a significant long-term complication related to lens epithelial cell behavior.
- Careful IOL placement, particularly ensuring loops are within the capsular envelope, is essential to prevent ciliary body erosion.
- Surgical technique for IOL removal should account for potential embedment of loops in ocular tissues.