Journal of cataract and refractive surgery最新文献_第4页

Accuracy of Predicted Refraction Using Two Swept-Source Optical Coherence Biometers and an Intraoperative Aberrometer.

IF 2.6 3区医学

Journal of cataract and refractive surgery Pub Date : 2025-02-11 DOI: 10.1097/j.jcrs.0000000000001628

Keizo Watanabe

{"title":"Accuracy of Predicted Refraction Using Two Swept-Source Optical Coherence Biometers and an Intraoperative Aberrometer.","authors":"Keizo Watanabe","doi":"10.1097/j.jcrs.0000000000001628","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001628","url":null,"abstract":"Purpose: To compare the refractive accuracy of Optiwave Refractive Analysis (ORA) using biometric measurements of ARGOS and OA-2000 in the same patient planned for a monofocal intraocular lens (IOL) insertion.Setting: Single center.Design: Prospective, observational study.Methods: Patients scheduled for cataract surgery between January 2021 and March 2022 (expected corrected distance visual acuity of ≥0.8 postoperatively at 1-3 months) underwent preoperative ocular measurements using ARGOS and OA-2000 biometers on the same day, which were entered into the intraoperative aberrometer ORA system to assess the refractive accuracy of the IOL implant and postoperative spherical equivalent at 1-3 months. The refractive accuracy was compared between ORA using ARGOS (ORA-AR) and ORA using OA-2000 (ORA-OA). The primary endpoint was the comparison of the mean absolute refractive prediction error (MAE) between the ORA-AR and ORA-OA methods.Results: A total of 117 eyes of 81 patients were evaluated (mean ± standard deviation [SD] age, 72.8 ± 7.4 years; male, 65.4%). The criteria for noninferiority were met between the ORA-AR and ORA-OA methods, as the upper boundary of the confidence interval (CI) was lower than the noninferiority margin of 0.10 D for the difference in MAE (-0.03 D; 95% CI: -0.061 to 0.001). MAE was numerically smaller with ORA-AR (0.243 ± 0.215 D) but not significantly different from that with ORA-OA (0.269 ± 0.246 D).Conclusions: Postoperative MAE obtained using ORA-AR was noninferior to that of ORA-OA. However, the MAE and SD of refractive prediction errors with ORA-AR were numerically lower compared with ORA-OA.","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Postoperative Walking vs. Lying Down on IOL Rotation After Lens Surgery: A Prospective Comparative Study.

IF 2.6 3区医学

Journal of cataract and refractive surgery Pub Date : 2025-02-11 DOI: 10.1097/j.jcrs.0000000000001632

Tyll Jandewerth, Klemens Paul Kaiser, Eva Hemkeppler, Christoph Lwowski, Thomas Kohnen

{"title":"Impact of Postoperative Walking vs. Lying Down on IOL Rotation After Lens Surgery: A Prospective Comparative Study.","authors":"Tyll Jandewerth, Klemens Paul Kaiser, Eva Hemkeppler, Christoph Lwowski, Thomas Kohnen","doi":"10.1097/j.jcrs.0000000000001632","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001632","url":null,"abstract":"Purpose: To determine the intraocular lens (IOL) rotational stability depending on patient position in the first postoperative hour after femtosecond laser assisted cataract or refractive surgery with implantation of a non-toric IOL in the capsular bag.Setting: Department of Ophthalmology, Goethe-University, Frankfurt, Germany.Design: Prospective, randomized clinical trial.Methods: In this study, 38 eyes of 36 patients received femtosecond laser assisted phacoemulsification and implantation of a non-toric IOL in the capsular bag. Patients were randomized into two groups: patients laid down for one hour after surgery due to the clinical standard (LD group), patients walked around in the first postoperative hour (W group). No miotic eye drops were applied at the end of operation. A retroilluminated slit lamp picture was taken at the end of the operation (baseline), one hour and one day postoperative. Changes in IOL position were measured by an axis between two episcleral landmarks and the haptics of the IOL. Measurements were performed by an image processing application specified for medical and scientific purpose. If not normally distributed, the paired t-test was used. Otherwise, the Mann-Whitney-U-Test was used if data was not normally distributed.Results: IOL rotation in the first hour was 1.80° ± 1.80° in the LD group and 1.21° ± 2.11° in the W group (p=0.123). One day after operation, IOL position differed from the baseline measurement with 1.52° ± 1.89° in the LD group and 1.51° ± 1.69° in the W group (p=0.773).Conclusion: Early postoperative patient position does not seem to influence IOL rotational stability.","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Severe intraocular lens tilt after the Yamane technique. Yamane 技术后严重的眼内晶状体倾斜。

IF 2.6 3区医学

Journal of cataract and refractive surgery Pub Date : 2025-02-01 DOI: 10.1097/j.jcrs.0000000000001575

Neil Kelkar, Kevin Eid, Austin S Nakatsuka, Catherine Johnson, Nick Mamalis, Liliana Werner

{"title":"Severe intraocular lens tilt after the Yamane technique.","authors":"Neil Kelkar, Kevin Eid, Austin S Nakatsuka, Catherine Johnson, Nick Mamalis, Liliana Werner","doi":"10.1097/j.jcrs.0000000000001575","DOIUrl":"10.1097/j.jcrs.0000000000001575","url":null,"abstract":"Purpose: To evaluate CT Lucia 602 intraocular lenses implanted in cases lacking capsular support and explanted because of decentration/dislocation with subsequent pathological analysis. The main objectives were to (1) document the status of haptics and (2) verify the presence of the rotisserie effect.Setting: John A. Moran Eye Center, University of Utah, Salt Lake City, Utah.Design: Case series with clinicopathological correlation.Methods: 13 explanted CT Lucia 602 lenses were included: 12 implanted by the Yamane technique and 1 that was iris-fixated. 4 lenses were explanted between October 2020 and February 2022. 9 lenses, explanted between November 2022 and February 2024, also exhibited severe optic tilt, leading to explantation. A chart review was performed to obtain clinical information from each case. Explanted lenses underwent gross and microscopic examination for haptic status and rotation, in the dry state (room temperature) and after hydration (body temperature).Results: Time between implantation and explantation was longer for lenses explanted before November 2022 (without severe tilt). Among the 26 haptics evaluated, 15 were deformed, 6 were broken, 2 were detached, and 3 were unremarkable. 4 haptics of Yamane lenses explanted between November 2022 and February 2024 showed free rotation within the optic insertion, after hydration at body temperature.Conclusions: Anecdotal reports of the rotisserie effect of CT Lucia 602 lenses implanted by the Yamane technique appeared mostly during the second half of 2022 and suggested that affected lenses were from specific batches, which seems to be consistent with the findings of this study.","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"126-132"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11757069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development of machine learning-based models for vault prediction in implantable collamer lens surgery according to implant orientation.

IF 2.6 3区医学

Journal of cataract and refractive surgery Pub Date : 2025-01-31 DOI: 10.1097/j.jcrs.0000000000001623

Timoteo González-Cruces, Francisco Javier Aguilar-Salazar, Jordi Marfany Tort, Álvaro Sánchez-Ventosa, Alberto Villarrubia, Jose Lamarca Mateu, Rafael I Barraquer, Sergio Pardina, David Cerdán Palacios, Antonio Cano-Ortiz

{"title":"Development of machine learning-based models for vault prediction in implantable collamer lens surgery according to implant orientation.","authors":"Timoteo González-Cruces, Francisco Javier Aguilar-Salazar, Jordi Marfany Tort, Álvaro Sánchez-Ventosa, Alberto Villarrubia, Jose Lamarca Mateu, Rafael I Barraquer, Sergio Pardina, David Cerdán Palacios, Antonio Cano-Ortiz","doi":"10.1097/j.jcrs.0000000000001623","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001623","url":null,"abstract":"Purpose: The main objective was to develop a prediction model based on machine learning to calculate the postoperative vault as well as the ideal implantable collamer lens (ICL) size, considering for the first time the implantation orientation in a Caucasian population.Setting: Arruzafa Ophthalmological Hospital (Cordoba, Spain) and Barraquer Ophthalmology Center (Barcelona, Spain).Design: Multicenter, randomized, retrospective study.Methods: Anterior segment biometric data from 235 eyes of patients who underwent ICL lens implantation surgery were collected using the anterior segment optical coherence tomography (AS-OCT) CASIA II, to train and validate five types of multiple regression models based on advanced machine learning techniques. To perform an external validation a dataset of 45 observations was used.Results: The Pearson correlation coefficient between observed and predicted values was similar in the five models in the external validation, with least absolute shrinkage and selection operator (LASSO) regression being the highest (r = 0.62, p < 0.001), followed by random forest regression model (r = 0.60, p < 0.001) and backward stepwise regression (r = 0.58, ρ < 0.001). In addition, the predictions generated by the different models showed closer agreement with the actual vault compared with the Nakamura formulas. Using the new methods, about 70% of the observations had a prediction error below 150 µm.Conclusions: Advanced forms of regressions models based on machine learning allow satisfactory calculation of the ideal lens size, offering greater precision to surgeons customizing surgery according to implant orientation.","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Evaluation of Nd:YAG Capsulotomy on the Light-Adjustable Intraocular Lens.

IF 2.6 3区医学

Journal of cataract and refractive surgery Pub Date : 2025-01-31 DOI: 10.1097/j.jcrs.0000000000001621

Ashley A Abing, Jimmy K Lee, Dan B Tran, Amir H Marvasti

{"title":"Clinical Evaluation of Nd:YAG Capsulotomy on the Light-Adjustable Intraocular Lens.","authors":"Ashley A Abing, Jimmy K Lee, Dan B Tran, Amir H Marvasti","doi":"10.1097/j.jcrs.0000000000001621","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001621","url":null,"abstract":"Purpose: To investigate the safety and refractive outcomes of neodymium-doped yttrium-aluminum-garnet (Nd:YAG) capsulotomy in pseudophakic eyes with the Light Adjustable Lens (LAL) both before and after completing the light delivery device (LDD) lock-in treatments.Setting: Private practice in Orange, California, USA.Design: Retrospective, comparative study.Methods: Patients were divided into two groups according to the timing of their YAG capsulotomy (Group I underwent YAG capsulotomy before lock-in treatments and Group II underwent YAG capsulotomy upon completion of lock-in treatments). Sphere, cylinder, axis, spherical equivalent, uncorrected visual acuity, and best-corrected visual acuity were compared pre- and postoperatively using two-tailed paired t-tests. Postoperative data were measured one month after Nd:YAG capsulotomy. The alpha level (type I error) was set at 0.05.Results: The LAL was successfully implanted in 485 eyes from January 2020 to March 2023. Ten eyes (0.02%) needed YAG capsulotomy prior to the completion of lock-in treatments (Group I) and 28 eyes (5.77%) needed YAG capsulotomy after the lock-in was completed (Group II). Postoperative BCVA significantly improved compared to preoperative values in both groups. Changes in sphere, cylinder, axis, SE, and UCVA pre- and postoperative measurements were not statistically significant (p > 0.05) in both groups.Conclusions: YAG capsulotomy can be safe and effective for patients with the LAL who develop PCO during the adjustment period. There were no significant changes in sphere, cylinder, axis, or spherical equivalence after YAG capsulotomy in both groups.","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessing chatbots ability to produce leaflets on cataract surgery: Bing AI, chatGPT 3.5, chatGPT 4o, ChatSonic, Google Bard, Perplexity and Pi.

IF 2.6 3区医学

Journal of cataract and refractive surgery Pub Date : 2025-01-31 DOI: 10.1097/j.jcrs.0000000000001622

Dr Polly Thompson, Dr Richard Thornton, Mr Conor Ramsden

{"title":"Assessing chatbots ability to produce leaflets on cataract surgery: Bing AI, chatGPT 3.5, chatGPT 4o, ChatSonic, Google Bard, Perplexity and Pi.","authors":"Dr Polly Thompson, Dr Richard Thornton, Mr Conor Ramsden","doi":"10.1097/j.jcrs.0000000000001622","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001622","url":null,"abstract":"Purpose: This study aimed to evaluate leaflets on cataract surgery produced by seven common free chatbots.Setting: Usage of conversational artificial intelligence services (chatbots) is becoming more prevalent in all aspects of life, including healthcare. Cataract surgery is the most commonly performed operation in the world, with numbers set to increase. Possible applications for chatbots include information giving and education, allowing clinicians to allocate their time more efficiently.Design: Analysis of answers given by seven chatbots (Bing AI, chatGPT 3.5, chatGPT 4o, ChatSonic, Google Bard, Perplexity and Pi) were prompted to \"make a patient information leaflet on cataract surgery\".Methods: Answers were evaluated using the DISCERN instrument, Patient Education Materials Assessment Tool (PEMAT), presence of misinformation, the Flesch-Kincaid Grade Level readability score and material reliability.Results: The highest overall scored response was from ChatSonic, followed by Bing AI and then Perplexity. The lowest scoring was ChatGPT 3.5.ChatSonic achieved the highest DISCERN and PEMAT scores, and had the highest Flesch-Kincaid Grade level. The lowest DISCERN and PEMAT scores were for Pi. Only ChatGPT 3.5 included some misinformation in its response. Bing AI, ChatSonic and Perplexity included reliable references; the other chatbots provided no references.Conclusions: This study demonstrates a range of answers given by chatbots creating a cataract surgery leaflet, suggesting variation in their development and reliability. ChatGPT 3.5 scored the most poorly. However, ChatSonic indicated promise in how technology may be used to assist information giving in ophthalmology.","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes of Zero Power Intraocular Lenses: Insights into the Keratometric Index and Axial Length.

IF 2.6 3区医学

Journal of cataract and refractive surgery Pub Date : 2025-01-31 DOI: 10.1097/j.jcrs.0000000000001624

Ronald B Melles, David L Cooke, Thomas Olsen

{"title":"Outcomes of Zero Power Intraocular Lenses: Insights into the Keratometric Index and Axial Length.","authors":"Ronald B Melles, David L Cooke, Thomas Olsen","doi":"10.1097/j.jcrs.0000000000001624","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001624","url":null,"abstract":"Purpose: We analyzed intraocular lens (IOL) power calculation in a series of patients with a zero diopter power implant. The idea was to bypass the Estimated Lens Plane (ELP), an important variable in normal IOL calculation.Setting: Large multi-center group practice.Design: Retrospective, observational study.Methods: A consecutive series of patients undergoing cataract surgery after optical biometry and implantation of a zero (0.0 D) power IOL were studied. Complete biometry was performed with an optical low coherence optical biometer. The predicted refraction was calculated with and without recalibrating the axial length (AL) using a Sum-Of-Segments (SOS) approach with the Hoffer Q, Holladay 1, SRK/T, Haigis, Barrett Universal II, and Olsen formulas. A ray tracing model to back-calculate the corneal power from the observed postoperative refraction and AL was also included.Results: In 52 eyes of 52 patients, mean prediction errors for the Hoffer Q, Holladay 1, SRK/T, Haigis, Barrett Universal II, and the Olsen formulas were +1.48, +1.15, +0.91, +0.65, +0.15 and +0.11 D respectively using standard AL and after SOS correction of the AL the mean errors changed to +1.08, +0.75, +0.52, +0.26, -0.25, and -0.27 D respectively. The mean back-calculated corneal power was 1.25 D lower than the mean keratometer reading using the standard keratometric index of 1.3375 and corresponded to an effective index of 1.328.Conclusions: The hyperopic error commonly seen in highly myopic eyes with classical thin-lens formulas is only partly corrected by SOS recalibration of the AL. We suggest the source of the residual error is an incorrect keratometric index.","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Using a large language model to process biometry reports and select intraocular lens for cataract surgery.

IF 2.6 3区医学

Journal of cataract and refractive surgery Pub Date : 2025-01-31 DOI: 10.1097/j.jcrs.0000000000001620

Jeremy C K Tan

引用次数: 0

Dissatisfaction after implantation of extended depth-of-focus intraocular lenses.

IF 2.6 3区医学

Journal of cataract and refractive surgery Pub Date : 2025-01-21 DOI: 10.1097/j.jcrs.0000000000001615

Joukje C Wanten, Noël J C Bauer, Tos T J M Berendschot, Frank J H M van den Biggelaar, Rudy M M A Nuijts

{"title":"Dissatisfaction after implantation of extended depth-of-focus intraocular lenses.","authors":"Joukje C Wanten, Noël J C Bauer, Tos T J M Berendschot, Frank J H M van den Biggelaar, Rudy M M A Nuijts","doi":"10.1097/j.jcrs.0000000000001615","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001615","url":null,"abstract":"Purpose: To evaluate the symptoms, etiology and treatment of patient dissatisfaction after extended depth-of-focus (EDOF) intraocular lens (IOL) implantation.Setting: University Eye Clinic, Maastricht University Medical Center, the Netherlands.Design: Retrospective case series.Methods: For this study, all medical records of patients who received an EDOF IOL from July 2020 to July 2022 were reviewed. Patients were included if they had reported any dissatisfaction after surgery. The main outcome parameters were reasons for dissatisfaction (subjective complaints) and the presumed etiology of the complaints.Results: Out of 202 patients (354 eyes) who underwent EDOF IOL implantation, 83 eyes (22.8%) of 52 dissatisfied patients were included. Blurred vision was the predominant complaint, reported in 78 eyes (94%). Photic phenomena were reported in 21 eyes (25.3%), with 16 eyes (76.2%) experiencing coexisting blurred vision. The major etiologies for dissatisfaction in this cohort were residual ametropia (51.8%), dry eye disease (26.5%), and posterior capsular opacification (12.0%). Treatments were administered to 85.5% of the eyes, including interventions such as artificial tears, spectacles, or refractive surgery enhancement. A small number of patients (n=12; 5.9%) remained dissatisfied despite intervention.Conclusion: Based on this real-world data study, dissatisfaction following EDOF IOL implantation can be effectively identified and treated in most cases.","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Histopathological Characteristics of Zonular Fibers and Lens Capsule and Their Relationship to Clinical Features in Intraocular Lens Dislocation.

IF 2.6 3区医学

Journal of cataract and refractive surgery Pub Date : 2025-01-21 DOI: 10.1097/j.jcrs.0000000000001607

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":"https://doi.org/10.1097/j.jcrs.0000000000001607","url":null,"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.","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0