Title:
1Cataract 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
2Center 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
309/02 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
4Phakic 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?
5Crystalline lens
6Anterior 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)
7A-cells Anterior capsule opacification
8A-cells Capsule contraction syndrome
9A-cells Anterior capsule opacification
10A-cells anterior subcapsular cataract after
Staar ICL implantation
OS
OD
Courtesy Paul Koch, MD, Koch Eye Surgicenter,
Inc., Warwick, RI, USA
11A-cells anterior subcapsular cataract after
Staar ICL implantation
Courtesy Arturo Chayet, MD, Mexico
12Anterior Capsule Opacification
Anterior Subcapsular Cataract (Uveitis)
Anterior Subcapsular Cataract (Phakic IOL)
13E-cells Posterior capsule opacification
Rabbit eye
14E-cells Posterior capsule opacification
Cadaver eye
15E-cells Interlenticular opacification
16E-cells Interlenticular opacification
Material between piggyback lenses
Cataractous lens (Ocular Pathology David J.
Apple, Maurice F. Rabb 1998 - 5th Edition)
17Phakic 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?
18Phakic 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
19First generation Fyodorov mushroom lens
Courtesy Dimitrii D. Dementiev, MD, Milano,
Italy
20First generation Fyodorov mushroom lens
Courtesy Dimitrii D. Dementiev, MD, Milano,
Italy
21Second generation Chiron-Adatomed silicone lens