Akira Hirata, Keiko Mine, Ken Hayashi, Keisuke Ohta
{"title":"Histopathological Characteristics of Zonular Fibers and Lens Capsule and Their Relationship to Clinical Features in Intraocular Lens Dislocation.","authors":"Akira Hirata, Keiko Mine, Ken Hayashi, Keisuke Ohta","doi":"10.1097/j.jcrs.0000000000001607","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To identify the histopathologic changes in the lens capsule of eyes with in-the-bag intraocular lens (IOL) dislocation.</p><p><strong>Design: </strong>Pathological analysis and correlation with clinical findings.</p><p><strong>Setting: </strong>Hayashi Eye Hospital (Fukuoka, Japan).</p><p><strong>Methods: </strong>Specimens of twenty-five IOL-lens capsule complexes obtained during surgery were processed for scanning electron microscopy (SEM). Backscattered electron images of cross-sections of the lens capsule were obtained using SEM. Ultrastructural changes in the lens capsule were examined and analyzed based on preoperative clinical findings.</p><p><strong>Results: </strong>The mean age was 70.0±18.0 years. The mean time from initial cataract surgery to IOL removal was 12.5±7.0 years. Of these, nine eyes had exfoliation syndrome (XFS), seven had high myopia, five underwent vitrectomy, and three had atopic dermatitis. The mean age of the XFS cases was 86.6±4.3 years. All XFS specimens demonstrated highly associated ruptured zonular fibers (p <.01). In the 16 non-XFS cases, the mean age was 61.2±17.5 years, significantly younger than in the XFS cases (p <.01); 14 of the 16 specimens had a detachment of zonular lamella (ZL), which was highly associated (p <.01). Four non-XFS eyes exhibited clear capsules, demonstrating significant associations with capsular delamination (p < .01) and the absence of lens epithelial cells (p < .01), resembling dead-bag syndrome.</p><p><strong>Conclusions: </strong>Structural changes in the lens capsule associated with IOL dislocation are mainly of three types: ruptured zonular fibers in XFS, detachment of the ZL, and capsular delamination. They vary according to the associated diseases, suggesting that prevention and treatment should consider the underlying pathophysiology.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cataract and refractive surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/j.jcrs.0000000000001607","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: To identify the histopathologic changes in the lens capsule of eyes with in-the-bag intraocular lens (IOL) dislocation.
Design: Pathological analysis and correlation with clinical findings.
Setting: Hayashi Eye Hospital (Fukuoka, Japan).
Methods: Specimens of twenty-five IOL-lens capsule complexes obtained during surgery were processed for scanning electron microscopy (SEM). Backscattered electron images of cross-sections of the lens capsule were obtained using SEM. Ultrastructural changes in the lens capsule were examined and analyzed based on preoperative clinical findings.
Results: The mean age was 70.0±18.0 years. The mean time from initial cataract surgery to IOL removal was 12.5±7.0 years. Of these, nine eyes had exfoliation syndrome (XFS), seven had high myopia, five underwent vitrectomy, and three had atopic dermatitis. The mean age of the XFS cases was 86.6±4.3 years. All XFS specimens demonstrated highly associated ruptured zonular fibers (p <.01). In the 16 non-XFS cases, the mean age was 61.2±17.5 years, significantly younger than in the XFS cases (p <.01); 14 of the 16 specimens had a detachment of zonular lamella (ZL), which was highly associated (p <.01). Four non-XFS eyes exhibited clear capsules, demonstrating significant associations with capsular delamination (p < .01) and the absence of lens epithelial cells (p < .01), resembling dead-bag syndrome.
Conclusions: Structural changes in the lens capsule associated with IOL dislocation are mainly of three types: ruptured zonular fibers in XFS, detachment of the ZL, and capsular delamination. They vary according to the associated diseases, suggesting that prevention and treatment should consider the underlying pathophysiology.
期刊介绍:
The Journal of Cataract & Refractive Surgery (JCRS), a preeminent peer-reviewed monthly ophthalmology publication, is the official journal of the American Society of Cataract and Refractive Surgery (ASCRS) and the European Society of Cataract and Refractive Surgeons (ESCRS).
JCRS publishes high quality articles on all aspects of anterior segment surgery. In addition to original clinical studies, the journal features a consultation section, practical techniques, important cases, and reviews as well as basic science articles.