Korean J Ophthalmol.  2014 Dec;28(6):486-492. 10.3341/kjo.2014.28.6.486.

Introduction of Lens-angle Reconstruction Surgery in Rabbit Eyes

• Kim MH
• Hwang HS
• Park KJ
• Hwang JH
• Joo CK

• KMID: 2345826
• DOI: http://doi.org/10.3341/kjo.2014.28.6.486

Abstract

PURPOSE
In this study, we examined the stability of the lens-angle supporter (LAS) for accommodation restoration by comparing intraocular lens (IOL) location, after-cataract and ciliary body damage after cataract surgery in rabbits.
METHODS
Eight rabbits were divided into experimental and control groups of four rabbits each. Phacoemulsification and irrigation and aspiration were performed in all rabbits. This was followed by an LAS and IOL insertion in the four experimental rabbits. In the four control rabbits, only an IOL insertion was performed. Six months after the surgery, the location of the IOL, the conditions of the lens capsule and ciliary body were evaluated using a slitl-amp examination and Miyake-Apple view.
RESULTS
For the experimental group, the ultrasound biomicroscope results showed normal LAS and IOL positioning in all four cases. According to the slitlamp examination and Miyake-Apple view, the IOL was positioned at the center, with less after-cataract and damage to the ciliary body. For the control group, ultrasound biomicroscope results indicated a higher IOL position than normal, as well as a single case of IOL decentering. According to the slit-lamp examination and Miyake-Apple view, the IOL was decentered with more severe after-cataract and ciliary body damage.
CONCLUSIONS
The LAS has the potential to maintain a stable IOL position while producing less after-cataract when used in lens-angle reconstruction for correction of presbyopia. Moreover, LAS implantation incurs less damage to the ciliary body.

Keyword

Accommodation; Cataract surgery; Presbyopia

MeSH Terms

Accommodation, Ocular/physiology
Animals
Anterior Eye Segment
Ciliary Body/injuries
Disease Models, Animal
Eye Injuries/*surgery
Lens Capsule, Crystalline/*surgery
*Lens Implantation, Intraocular
Microscopy, Acoustic
*Phacoemulsification
Rabbits
*Reconstructive Surgical Procedures

Figure

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  Fig. 1 (A) Schematic figure of anterior segment structure before cataract surgery. (B) Schematic figure of anterior segment structure after cataract surgery (phacoemulsification and posterior chamber lens implantation). (C) Schematic figure of anterior segment structure after cataract surgery using lens-angle supporter.

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  Fig. 2 (A) The lens-angle supporter is made of silicone elastomer and has a 9.0 to 12.0 mm diameter formed in 0.1 mm increments. (B) The injector for lens-angle supporter implantation.

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  Fig. 3 The inner diameter of the ciliary process (C1) was measured using the 25 MHz ultrasound biomicroscope for appropriate resolution and permeability. OD = right eye.

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  Fig. 4 Based on ultrasound biomicroscope results, the lens-angle supporter and intraocular lense showed normal positioning in all four cases. The lens angle was maintained and the posterior capsule was also observed (A-D). OD = right eye.

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  Fig. 5 According to slit-lamp examination, the intraocular lens was positioned at the center with less after-cataract (A-D).

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  Fig. 6 According to Miyake-Apple view, the intraocular lens was positioned at the center and had less ciliary body damage (A-D).

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  Fig. 7 According to ultrasound biomicroscope results, the control group showed cases which the intraocular lens was located at a higher position than normal (A,B), a case which the intraocular lens was decentered (C), and a case with normal intraocular lens positioning (D). OD = right eye.

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  Fig. 8 Slit-lamp examination revealed haptic-caused damage to the iris at the 1 o'clock location (A), a slanted intraocular lens (B), an after-cataract mass causing decentering of the intraocular lens at the 3 o'clock location (C), and a single case with normal intraocular lens positioning (D).

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  Fig. 9 In the Miyake-Apple view, most of the intraocular lens haptics protruded into the ciliary process. Excepting the single case (A) where only one haptic was seen, all of the other cases (B-D)showed that the ciliary body incurred damage and expanded in the direction of the intraocular lens haptic protrusion.

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