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“Cataract formation after implantation of phakic posterior chamber intraocular lenses: A 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
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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 Institute Medical University of South Carolina Charleston, SC, USA
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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 Utah Salt Lake City, UT, USA
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Phakic posterior chamber IOLs 1.Cells involved in crystalline lens and capsular bag opacification 2.Evolution of designs of PPCIOLs 3.Relevant aspects of fixation and sizing 4.Sizing issue: New studies 5.Surgical implantation 6.Relationship between cataract and myopia 7.Cataractogenesis Specimens analyzed in our Center Mechanisms Review of the literature Classification of cataracts after phakic IOL implantation?
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Crystalline lens
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Anterior capsuleEpithelial cells (A-cells) Cortical fibers Area of active mitosis (E-cells) Epithelial lens bow Posterior capsule Nucleus Anterior subcapsular cataract (A-cells) Interlenticular opacification (A-cells + E-cells) Posterior capsule opacification (A-cells + E-cells) Anterior capsule opacification (A-cells)
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A-cells: Anterior capsule opacification
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A-cells: Capsule contraction syndrome
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A-cells: Anterior capsule opacification
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Courtesy: Paul Koch, MD, Koch Eye Surgicenter, Inc., Warwick, RI, USA A-cells: anterior subcapsular cataract after Staar ICL implantation OD OS
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Courtesy: Arturo Chayet, MD, Mexico A-cells: anterior subcapsular cataract after Staar ICL implantation
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Anterior Capsule Opacification Anterior Subcapsular Cataract (Uveitis) Anterior Subcapsular Cataract (Phakic IOL)
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E-cells: Posterior capsule opacification Rabbit eye
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E-cells: Posterior capsule opacification Cadaver eye
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E-cells: Interlenticular opacification
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Cataractous lens (Ocular Pathology David J. Apple, Maurice F. Rabb 1998 - 5th Edition) Material between piggyback lenses
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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?
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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
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First generation: Fyodorov “mushroom” lens Courtesy: Dimitrii D. Dementiev, MD, Milano, Italy
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First generation: Fyodorov “mushroom” lens Courtesy: Dimitrii D. Dementiev, MD, Milano, Italy
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Second generation: Chiron-Adatomed silicone lens
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