Occurrence of anterior and posterior capsule opacification after cataract surgery with implantation of acrylic hydrophobic heparinized lenses in patients with diabetes type 2

Katarzyna Kubasik-Kładna, Marzena Formicka, Ewelina Lachowicz, Radosław Kiedrowicz, Tomasz Pabin, Wojciech Lubiński

Abstract


Introduction: A high incidence of capsule opacification was found in diabetic patients after cataract surgery. New surgical techniques and intraocular lens (IOL) modifications decrease posterior capsule opacification (PCO) appearance requiring posterior capsulotomy. It can be assumed that cataract surgery with implantation of heparin-surface-modified IOLs reduces the risk of PCO in patients with diabetes.

The aim of the study is assessment of the influence of acrylic hydrophobic heparinized lenses on the frequency and levels of anterior capsule opacification (ACO) and PCO and visual acuity in patients with diabetes mellitus type 2 after uncomplicated cataract surgery.

Materials and methods: Eighteen patients (36 eyes) with diabetes type 2, without retinopathy were involved in the prospective study. Standard cataract surgery was performed with implantation of acrylic hydrophobic heparinized lens (Polylens Y10AS) in 

one eye (study group) and a non-heparinized lens (Alcon SA60AT) in the opposite eye (control group). Three weeks, 6 months, and 1 year after surgery distance best corrected visual acuity (DBCVA) and assessment of ACO and PCO with retroillumination imaging results were obtained and statistically analysed.

Results: In patients with diabetes type 2 during 1 year follow-up (12 months) there were no statistically significant differences in the frequency of ACO and PCO between eyes with implantation of heparinized and non-heparinized lenses. There were no differences in mean DBCVA between groups during all follow-ups.

Conclusions: Our observations in patients with diabetes type 2, did not reveal greater biocompatibility of heparinized lenses compared to non-heparinized lenses.


Keywords


diabetes mellitus; cataract surgery; comparison of acrylic hydrophobic heparinized and non-heparinized lenses; DBCVA; capsule opacification

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References


Hayashi Y, Kato S, Fukushima H, Numaga J, Kaiya T, Tamaki Y, et al. Relationship between anterior capsule contraction and posterior capsule opacification after cataract surgery in patients with diabetes mellitus. J Cataract Refract Surg 2004;30(7):1517-20.

Raj SM, Vasavada AR, Johar SR, Vasavada VA, Vasavada VA. Post-operative capsular opacification: a review. Int J Biomed Sci 2007;3(4):237-50.

Birinci H, Kuruoğlu S, Oge I, Oge F, Acar E. Effect of intraocular lens and anterior capsule opening type on posterior capsule opacification. J Cataract Refract Surg 1999;25(8):1140-6.

Pandey SK, Apple DJ, Werner L, Maloof AJ, Milverton EJ. Posterior capsule opacification: a review of the aetiopathogenesis, experimental and clinical studies and factors for prevention. Indian J Ophthalmol 2004;52(2):99-112.

Ebihara Y, Kato S, Oshoka T, Yoshizaki M, Sugita G. Posteriori capsule opacification after cataract surgery in patients with diabetes mellitus. J Cataract Refract Surg 2006;32:1184-7.

Vasavada AR, Praveen MR. Posterior capsule opacification after phacoemulsification: annual review. Asia Pac J Ophthalmol (Phila) 2014;3(4):235-40. doi: 10.1097/APO.0000000000000080.

Rönbeck M, Zetterström C, Wejde G, Kugelberg M. Comparison of posterior capsule opacification development with 3 intraocular lens types. J Cataract Refract Surg 2009;35:1935-40.

Abela-Formanek C, Amon M, Kahraman G, Schauersberger J, Dunavoelgyi R. Biocompatibility of hydrophilic acrylic, hydrophobic acrylic, and silicone intraocular lenses in eyes with uveitis having cataract surgery: Long-term follow-up. J Cataract Refract Surg 2011;37(1):104-12.

Zaczek A, Zetterström C. Posterior capsule opacification after phacoemulsification in patients with diabetes mellitus. J Cataract Refract Surg 1999;25(2):233-7.

Wejde G, Kugelberg M, Zetterström C. Posterior capsule opacification: comparison of 3 intraocular lenses of different materials and design. J Cataract Refract Surg 2003;29(8):1556-9.

Trocme SD, Li H. Effect of heparin-surface-modified intraocular lenses on postoperative inflammation after phacoemulsification: a randomized trial in a United States patient population. Heparin-Surface-Modified Lens Study Group. Ophthalmology 2000;107(6):1031-7.

Tabbara KF, Al-Kaff AS, Al-Rajhi AA, Al-Mansouri SM, Badr IA, Chavis PS, et al. Heparin surface-modified intraocular lenses in patients with inactive uveitis or diabetes. Ophthalmology 1998;105(5):843-5.

Mester U, Strauss M, Grewing R. Biocompatibility and blood-aqueous barrier impairment in at-risk eyes with heparin-surface-modified or unmodified lenses. J Cataract Refract Surg 1998;24(3):380-4.

Tognetto D, Ravalico G. Inflammatory cell adhesion and surface defects on heparin-surface-modified poly(methyl methacrylate) intraocular lenses in diabetic patients. J Cataract Refract Surg 2001;27(2):239-44.

Kang S, Kim MJ, Park SH, Joo CK. Comparison of clinical results between heparin surface modified hydrophilic acrylic and hydrophobic acrylic intraocular lens. Eur J Ophthalmol 2008;18(3):377-83.

Awan MT, Khan MA, Al-Khairy S, Malik S. Improvement of visual acuity in diabetic and nondiabetic patients after Nd:YAG laser capsulotomy. Clin Ophthalmol 2013;7:2011-7.

Lizárraga M. IOL Opacification, 2015. http://eyewiki.aao.org/IOL_Opacification (1.09.2016).

Alió JL, Chipont E, BenEzra D, Fakhry MA. Comparative performance of intraocular lenses in eyes with cataract and uveitis. J Cataract Refract Surg 2002;28(12):2096-108.

Gatinel D, Lebrun T, Le Toumelin P, Chaine G. Aqueous flare induced by heparin-surface-modified poly(methyl methacrylate) and acrylic lenses implanted through the same-size incision in patients with diabetes. J Cataract Refract Surg 2001;27(6):855-60.

Koraszewska-Matuszewska B, Samochowiec-Donocik E, Pieczara E, Filipek E. Wszczepy soczewek heparynizowanych u dzieci we wczesnym i późnym okresie obserwacji. Klin Ocz 2003;105(5):273-6.

Jeganathan VSJ, Wang JJ, Wong TY. Ocular associations of diabetes other than diabetic retinopathy. Diabetes Care 2008;31(9):1905-12.

Olokoba AB, Obateru OA, Olokoba LB. Type 2 diabetes mellitus: a review of current trends. Oman Med J 2012;27(4):269-73. doi: 10.5001/omj.2012.68.

Maedel S, Hirnschall N, Chen YA, Findl O. Effect of heparin coating of a foldable intraocular lens on inflammation and capsular bag performance after cataract surgery. J Cataract Refract Surg 2013;39(12):1810-7.

Praveen MR, Vasavada AR, Shah GD, Shah AR, Khamar BM, Dave KH. A prospective evaluation of posterior capsule opacification in eyes with diabetes mellitus: a case-control study. Eye 2014;28:720-7.

Elgohary MA, Hollick J, Bender LE, Heatley CJ, Wren SM, Boyce J, et al. Hydrophobic acrylic and plate-haptic silicone intraocular lens implantation in diabetic patients. Pilot randomized clinical trial. J Cataract Refract Surg 2006;32:1188-95.




DOI: https://doi.org/10.21164/pomjlifesci.335

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