Findings on IOL Calcification: A new Classification

Size: px

Start display at page:

Download "Findings on IOL Calcification: A new Classification"

Crystal Kennedy
5 years ago
Views:

for Research on Ophthalmic Devices Salt Lake City, Utah Apple Korps 1972-2008 ( 210 ) Research Fellows from

Legler, MD Irmi Neuhann, Md Ute Nicolei, MD Seung Jeong Lim, MD H. Sandoval, MD J. Schmidbauer, MD M.R.

Apple Laboratories for Ophthalmic Devices Research Neuhann IM, Kleinmann G, Apple DJ.

s Island, South Carolina Hydrogel (Hydrophilic acrylic) Opacifications: Partial Listing of Manufacturers:

1 for Research on Ophthalmic Devices Salt Lake City, Utah Apple Korps ( 210 ) Research Fellows from Germany G.U. Auffarth, MD M.P. Holzer, MD E. Imkamp, MD G. Kleinmann U. Legler, MD Irmi Neuhann, Md Ute Nicolei, MD Seung Jeong Lim, MD H. Sandoval, MD J. Schmidbauer, MD M.R. Tetz, MD Th. Wesendahl, MD Findings on Calcification: A new Classification David J. Apple Laboratories for Ophthalmic Devices Research Neuhann IM, Kleinmann G, Apple DJ. A new Classification of Calcification of Intraocular Lenses Ophthalmology, Brownell Ave, Sullivan s Island, South Carolina Hydrogel (Hydrophilic acrylic) Opacifications: Partial Listing of Manufacturers: Bausch and Lomb (B and L) Cibavision Medical Developmental Research (MDR) Ophthalmic Innovations International (OII) International Ophthalmic Devices (IOD) Mediphakos and multiple sub-distributors 1

2 Classification of Calcification Classification of Calcification 1. Primary 2. Secondary 1. Primary Primary calcification: The should be withdrawn or modified Calcification Primary Problem with Material/Fabrication MDR OII Others Secondary Pre-existing Disease or Intraoperative Conditions 2

condition associated with breakdown of the blood aqueous

, Broken Capsule Secondary calcification is by definition

3 Classification of Calcification 2. Secondary Some Causes of Secondary Calcification Any condition associated with breakdown of the blood aqueous barrier Diabetes Uveitis PHPV Surgical, eg., Broken Capsule Secondary calcification is by definition not related; it may occur with virtually all designs implanted under various adverse circumstances. 3

K leinm ann et al; O pacification of Hydrophilic Acrylic Lenses in Children Fig. No. 1 A B C D E F Is there a role for hydrophilic acrylic materials for s?

4 K leinm ann et al; O pacification of Hydrophilic Acrylic Lenses in Children Fig. No. 1 A B C D E F Is there a role for hydrophilic acrylic materials for s? MODERN well-designed, wellmanufactured and well-implanted hydrophilic acrylic s can be desirable in certain clinical situations. But, what about calcification? Microanalysis of Opacified Hydrophillic Acrylic Intra Ocular Lenses (Aqua-Sense) H. Porooshani, R. Williams, M. Batterbury Calcification Study Comparison of Calcification of Three Intraocular Lens Materials, Hydrophilic and Hydrophobic Acrylic, and Silicone Roger F. Steinert, M.D. Vice-chair Clinical Ophthalmology Director of Cornea, Refractive and Cataract Surgery University of California, Irvine Rakhi Jain, Ph.D. Purpose: To compare s of different materials in the same model system of calcification Method: 3 s per group implanted subcutaneously for 10 weeks in New Zealand White rabbits Lens analysis: Scanning electron microscopy () of central portion of at 500X Identifies surface morphology (deposits, pits, nodules) Energy-dispersive x-ray spectroscopy () of central portion of Elements release X-rays with unique amounts of energy Identifies elemental composition of sample sampled at same place on optic as photo 4

Hydrophilic Acrylic s Hydrophilic Acrylic s Acri.

present for both s No nitrogen (N) peak* Pits,

Rayner Centerflex Phosphorus (P) peak present Calcium

Corneal *No DJ Apple, nitrogen MD in suggests

phosphorus (P) or calcium (Ca) peaks for either No

optic Clariflex silicone Silicon (Si) peak due to

Classification of Calcification No reported primary

5 Hydrophilic Acrylic s Hydrophilic Acrylic s Acri.Smart Phosphorus (P) peak present Calcium (Ca) peak present for both s No nitrogen (N) peak* Pits, nodules and deposits on the surface of the optic Rayner Centerflex Phosphorus (P) peak present Calcium (Ca) peak present for both s Pits, nodules and deposits on the surface of the optic Akreos Fit Corneal *No DJ Apple, nitrogen MD in suggests deposits are not cellular Hydrophobic Acrylic s No phosphorus (P) or calcium (Ca) peaks for either No pits, nodules or deposits on the surface of either optic Clariflex silicone Silicon (Si) peak due to silicon in AR40e acrylic Fluorine (F) peak due to fluorine in D. Apple, Salt Lake Rayner Centreflex and B&O Akreos Classification of Calcification No reported primary calcification Rare but significant secondary calcification 1. Primary 2. Secondary Thank You! 5

6 6

Every week, the John A. Moran Eye Center at the

Analyzing Explanted IOLs A review of the pathological processes that affect pseudophakic patients postoperative vision. BY LILIANA WERNER, MD, PHD Every week, the John A. Moran Eye Center at the University