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The evolution of the restoration of accommodation by lens refilling and PCO: current status

Session Details

Session Title: New evaluation tools in refractive surgery

Session Date/Time: Sunday 06/10/2013 | 08:00-09:30

Paper Time: 08:12

Venue: Forum (Ground Floor)

First Author: : E.Arrieta USA

Co Author(s): :    M. Aguilar   S. Yoo   Y. Takesue   V. Fernandez   B. Holden   J. Parel

Abstract Details

Purpose:

To describe the evolution of a novel endocapsular surgery following the implantation of a soft polymer in the capsular bag to restore accommodation and methods used to prevent lens epithelium proliferation (LEC)

Setting:

Ophthalmic Biophysics Center. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine. Miami. Florida. USA

Methods:

Lens refilling has been performed in rabbits and primates by several investigators. Accommodation can now be assessed in human and non-human primates eyes using EVAS (ex-vivo accommodation simulator) coupled to novel OCT and UBM technologies capable of recording lens profile during stretching. New photo-crosslinkable polymers that approximate the index of refraction and modulus of elasticity of the natural crystalline lens were developed and tested in EVAS and live rabbits and the surgical technique was further refined for long term follow-ups. LEC proliferation was established by clinical observation and histology

Results:

Lens refilling is feasible and a reproducible technique. Over 10 diopters of restored accommodation was obtained in the early postoperative period in non-human primates. Several pharmaceutical agents were used to prevent PCO in rabbits Minimal posterior capsular opacification was detected as early at 1 week in rabbits and 1 month in primates

Conclusions:

Restoration of accommodation is possible by refilling the lens capsule with an appropriate polymer however further studies are warranted to investigate the prevention of lens epithelium proliferation

Financial Interest:

NONE