Large-scale analysis of intraocular lens opacifications using digital automated detection software

Session Details

Session Title: Presented Poster Session: After Surgery

Venue: Poster Village: Pod 1

First Author: : C.Mastromonaco CANADA

Co Author(s): :    M. Balazsi   J. Burnier   M. Burnier                 

Abstract Details

Purpose:

Intraocular lens (IOL) biomaterial and design are features that may influence posterior capsular opacification (PCO) development.  Posterior capsular opacification (PCO) is the leading long-term complication of cataract surgery due to the remnant lens epithelial cells within the capsular bag. PCO detection was recently standardized using Automated Detector Opacification Software (ADOS) to detect the presence and extent of opacities. Herein, we have refined our software analysis (ADOS 2.0) to control for IOL color and studied the IOL factors that have implications in the development of opacifications, using our extensive database on eye bank eyes.

Setting:

The MUHC-McGill University Ocular Pathology & Translational Research Laboratory.

Methods:

Total of 440 eyes with IOLs were obtained with the date of cataract surgery and IOL model number. The capsular bag (CB) was removed and imaged using the Olympus DSX100 stereoscope. PCO outcome was quantified on CB images using ADOS 2.0. Intensity and area of the opacification within the IOL optic edge, intra-optic edge (IOE=intensity*area), and in Soemmering’s ring (SR=intensity*area) was measured. The blue-filtering and non-blue filtering IOLs were controlled and standardized for the difference in luminosity. Statistical analysis assessed which IOL characteristics (material, edge design, IOL implant time) and patient-related factors (gender, age) correlated with PCO.

Results:

The mean age and IOL implant time was 82+/- 8.32 years and 85.6 months. Significantly less IOE and SR opacities were seen in IOLs of hydrophobic acrylic material (p=0.0055,p<0.0001). Square edge optic design showed significantly less SR opacities compared with opti-edge and round edge design (p<0.0001). No differences were seen between haptic piece design in both IOE and SR. Blue-light filter lenses had significantly less SR opacities then non-filter lenses (p<0.0001). A positive relationship was demonstrated between IOL implant time and SR opacities (R= 0.281). No differences in IOE and SR based on gender or age.

Conclusions:

Our methodology was able to successfully control for IOL colour bias. Gender and age do not correlate with PCO. The IOL factors that reduce PCO include hydrophobic material and the square edge design. Blue-light filtering intraocular lenses displayed less PCO when compared to all lenses. Opacities in the surrounding capsule significantly increase with time of IOL presence in the capsular bag.

Financial Disclosure:

None