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Medical University of South Carolina. Charleston, SC, USA. 09/02: David J. ... Surgical implantation. Relationship between cataract and myopia. Cataractogenesis ... – PowerPoint PPT presentation

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1
Cataract formation after implantation ofphakic
posterior chamber intraocular lensesA brief
overview and review of the literature
  • Liliana Werner, MD, PhD
  • David J. Apple, MD
  • FDA Ophthalmic Devices Advisory Panel Meeting
  • August 2, 2002, Rockville, MD

2
Center for Research on Ocular Therapeutics and
Biodevices Director David J. Apple, MD Director
of Research Liliana Werner, MD,
PhD Post-Doctoral Fellows Suresh K. Pandey, MD,
Andrea M. Izak, MD
Storm Eye InstituteMedical University of South
CarolinaCharleston, SC, USA
3
09/02 David J. Apple MD Laboratories for
Ophthalmic Devices Research Directors David J.
Apple, MD, Nick Mamalis, MD Director of Research
Liliana Werner, MD, PhD Clinical Directors
Randall J. Olson, MD, Alan S. Crandall,
MD Instructors Suresh K. Pandey, MD, Andrea M.
Izak, MD
John A. Moran Eye Center, University of UtahSalt
Lake City, UT, USA
4
Phakic posterior chamber IOLs
  • Cells involved in crystalline lens and capsular
    bag opacification
  • Evolution of designs of PPCIOLs
  • Relevant aspects of fixation and sizing
  • Sizing issue New studies
  • Surgical implantation
  • Relationship between cataract and myopia
  • Cataractogenesis
  • Specimens analyzed in our Center
  • Mechanisms
  • Review of the literature
  • Classification of cataracts after phakic IOL
    implantation?

5
Crystalline lens
6
Anterior capsule
Epithelial cells (A-cells)
Cortical fibers
Area of active mitosis (E-cells)
Nucleus
Epithelial lens bow
Posterior capsule
Posterior capsule opacification (A-cells
E-cells)
7
A-cells Anterior capsule opacification
8
A-cells Capsule contraction syndrome
9
A-cells Anterior capsule opacification
10
A-cells anterior subcapsular cataract after
Staar ICL implantation
OS
OD
Courtesy Paul Koch, MD, Koch Eye Surgicenter,
Inc., Warwick, RI, USA
11
A-cells anterior subcapsular cataract after
Staar ICL implantation
Courtesy Arturo Chayet, MD, Mexico
12
Anterior Capsule Opacification
Anterior Subcapsular Cataract (Uveitis)
Anterior Subcapsular Cataract (Phakic IOL)
13
E-cells Posterior capsule opacification
Rabbit eye
14
E-cells Posterior capsule opacification
Cadaver eye
15
E-cells Interlenticular opacification
16
E-cells Interlenticular opacification
Material between piggyback lenses
Cataractous lens (Ocular Pathology David J.
Apple, Maurice F. Rabb 1998 - 5th Edition)
17
Phakic posterior chamber IOLs
  • Cells involved in crystalline lens and capsular
    bag opacification
  • Evolution of designs of PPCIOLs
  • Relevant aspects of fixation and sizing
  • Sizing issue New studies
  • Surgical implantation
  • Relationship between cataract and myopia
  • Cataractogenesis
  • Specimens analyzed in our Center
  • Mechanisms
  • Review of the literature
  • Classification of cataracts after phakic IOL
    implantation?

18
Phakic Posterior Chamber Intraocular Lenses
  • -Introduced by Fyodorov in 1986
  • -Avoid potential problems associated with phakic
    anterior chamber IOLs, such as corneal
    descompensation and pupil ovalization

Courtesy Professor Georges Baikoff, Marseille,
France
19
First generation Fyodorov mushroom lens
Courtesy Dimitrii D. Dementiev, MD, Milano,
Italy
20
First generation Fyodorov mushroom lens
Courtesy Dimitrii D. Dementiev, MD, Milano,
Italy
21
Second generation Chiron-Adatomed silicone lens
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