torsional fibrosis in the anterior capsule following lens implantation

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Torsional fibrosis in the anterior capsule following lens implantation. Kavita Gala David Spalton James Boyce Anish Dhital ST THOMAS’S HOSPITAL, LONDON No financial or proprietary interest No financial or proprietary interest. INTRODUCTION. - PowerPoint PPT Presentation

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Kavita GalaDavid SpaltonJames BoyceAnish Dhital

ST THOMAS’S HOSPITAL, LONDON

No financial or proprietary interest

No financial or proprietary interest

INTRODUCTION

• Torsional fibrotic changes are sometimes seen in the anterior capsule following lens implantation

• Typically, these have a clockwise spiralling appearance

AIM

To study the evolution of spiralling changes and analyze their relation to patient factors

METHODS

• Retrospective study

• Screened 5000 images from our database of retroillumination images for eyes with typical spiralling

• The sequences of the images for each eye obtained

• For every image, the next non spiralling image from the database taken as control

• Images of the other eye extracted

METHODS • Changes in spiralling over time observed

• POCO software used to measure PCO

• POCOman software used to measure rhexis area

IOL power Capsulorrhexis size PCO percentage at 2 years

Compared to control eyes

Spiralling example 1PHP 22.0 SN60WF OD

3 MTHS

1 yr 2 YRS

3 YRS

Spiralling example 2BAB 22.5 Tecnis ZM001 OD

1 MTH

6 MTHS 3 YRS

3 YRS

Control eye exampleATO 23.5 OS SN60WF

1 MTH

3 MTHS

2 YRS

1 YR

RESULTS

0

2

4

6

8

10

12

14

16

spiralling

control

IOL distribution in each group

RESULTSAVERAGE SPIRALLING

GROUPCONTROL GROUP P VALUE

OD:OS 16:8 12:12 ns

PCO (% area) 3.92 ± 5.83 2.19 ± 3.13 ns

Rhexis diameter (mm)

4.14 ± 1.910 4.98 ± 2.36 <0.0001

IOL Power 21.260 ± 2.918 20.670 ± 2.319 ns

CONCLUSION

• Spiralling changes are caused due to torsional forces induced while dialling the lens into the bag due to the IOL binding with the bag

• Spiralling appears to be induced at surgery and then remains unchanged

• These changes are more commonly seen with a smaller rhexis- presumably because there is more contact between IOL and the bag.

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