Original article
Evaluation of Lens Epithelial Cell Migration In Vivo at the Haptic-Optic Junction of a One-Piece Hydrophobic Acrylic Intraocular Lens

Presented in part at ESCRS, Paris, France, Sep 20, 2004.
https://doi.org/10.1016/j.ajo.2006.05.049Get rights and content

Purpose

To evaluate the pattern of lens epithelial cell (LEC) ingrowth behind the intraocular lens (IOL) optic in patients implanted with the AcrySof SA60AT one-piece IOL.

Design

Retrospective case series.

Methods

Patients implanted with the AcrySof SA60AT one-piece IOL with complete overlap of the capsulorrhexis and IOL optic and no ocular pathology were selected from the practices of six surgeons. High-resolution digital images of the distribution of LECs were captured. Circumferential location and extent of LEC growth behind the optic were measured.

Results

Mean ± SD follow-up was 13.2 ± 1.7 months for 40 patients (mean age 72 years). LEC migration beyond the edge of the IOL optic was displayed by 57.5% (23/40) of patients. LECs migrated into the visual axis in 22.5% (9/40) of patients, leading to a visual acuity of <6/9 (20/30) in 10% (4/40) of patients. Cell migration was located preferentially at the optic-haptic junction. Serial photographs were used to monitor LEC migration over time. In some cases, LECs extended from the opposing optic-haptic junctions to converge in the center of the IOL, creating a path across the optic.

Conclusions

The optic-haptic junction of the AcrySof one-piece IOL is a point of weakness in the barrier effect of the square-edge IOL design that provides migrating LECs access to the posterior capsule.

Section snippets

Methods

Fifty-two patients implanted with the SA60AT IOL for at least 10 months were chosen by six separate surgeons from their individual practices. Exclusion criteria included pseudoexfoliation, glaucoma, history of iritis, or surgical complications that would affect the assessment of PCO. To be included in the study, patients had to have 360 degrees of overlap of the anterior capsule and the IOL optic. Each practice was contacted by telephone with a request to review patients who had been implanted

Results

Fifty-two patients were selected for the study, 12 from an author’s practice (D.R.N.) and the remaining 40 from the practices of five other physicians. Inclusion/exclusion criteria for 12 eyes could not be verified by slit-lamp examination, leaving a total of 40 eyes from 40 patients. The mean ± SD follow-up time was 13.2 ± 1.7 months (range 9.7 to 16.1 months). The average patient age was aged 72 ± 6.7 years (range 55 to 85 years), and 68.7% of the patients were women. The average diopter of

Discussion

The current study demonstrates a preferential distribution of migrating LECs in the vicinity of the optic-haptic junction in eyes implanted with the one-piece AcrySof SA60AT IOL. The study is descriptive in nature, so investigator bias must be taken into account. However, every effort was taken to maintain objectivity. The study subjects were chosen by practitioners or staff with no knowledge of the study purpose beyond that it was an assessment of the SA60AT IOL. All photography used

Cited by (22)

  • Femtosecond laser induced nano-textured micropatterning to regulate cell functions on implanted biomaterials

    2020, Acta Biomaterialia
    Citation Excerpt :

    It has been reported that the square edge of IOL reduces the PCO rate. It would appear that the square edge of posterior lens represents a mechanical barrier for the migration of LEC onto the posterior capsule [17,18,46]. However, the square edge design is beneficial to reduce the PCO rate, Nd:YAG laser capsulotomy is still required for the restoration of visual acuity, although the lower incidence [47].

  • Evaluation of a new single-piece 4% water content hydrophobic acrylic intraocular lens in the rabbit model

    2012, Journal of Cataract and Refractive Surgery
    Citation Excerpt :

    Because the haptics in this IOL are as thick as the optic component, there is a lack of barrier effect at the level of the optic–haptic junction. The thickness of the haptic also prevents capsular bend formation and adhesion between anterior and posterior capsules at the haptic root.11,12 Since the above-mentioned observations, modifications at the level of optic–haptic junctions have been proposed to address the potential lack of a 360-degree square-edged barrier in different IOL designs.

  • Hydrophobic versus double-square-edged hydrophilic foldable acrylic intraocular lens: Effect on posterior capsule opacification

    2011, Journal of Cataract and Refractive Surgery
    Citation Excerpt :

    The optic–haptic junction is another important factor in preventing PCO. The optic–haptic junction of the AcrySof SA60AT IOL diminishes the barrier effect of the square-edged IOL design and gives migrating LECs access to the posterior capsule.28 In 1 study,29 eyes with an IOL with a continuous 360-degree square edge had significantly less PCO than eyes with an IOL with a square edge that was interrupted at the optic–haptic junction, such as the hydrophobic IOL we used in our study.

View all citing articles on Scopus

Supported in part by an unrestricted grant from Advanced Medical Optics Inc.

View full text