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Changes in the crystalline lens resulting from insertion of a phakic IOL (ICL) into the porcine eye

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Abstract

Background

Insertion of a phakic IOL offers these advantages: the corneal optical zone is not dissected or resected; preservation of the crystalline lens results in preservation of the accommodation force; and since the phakic IOL is removable, any error or change in refraction can be countered by exchanging it. However, the cause of secondary cataracts has never been clarified or discussed to date.

Methods

The following ICL lenses were inserted under general anaesthesia into 20 eyes of ten 3-month-old miniature pigs: a minus lens without holes into five eyes, a plus lens in two eyes, a minus lens with four holes around the lens haptics in three eyes, and a minus lens with a central hole in the optic in three eyes; and seven eyes were used as controls. The anterior segments were then photographed 1 week, 1 month and 3 months after surgery. At 3 months after surgery, Evans blue (EB) was infused into the vitreous under general anaesthesia, and after 30 min, the eyeball was enucleated, fixed and examined.

Results

In the case of the ICL without holes, the anterior subcapsular opacities were observed in all the eyes, and the anterior surfaces of the crystalline lenses were not stained with EB. Use of the ICL with four holes around the lens haptics resulted in light staining of the anterior surface of the crystalline lens, but the anterior subcapsular opacities observed were mild. As for the ICL with a hole in the centre of the optic, the anterior surface of the crystalline lens was stained and no anterior subcapsular opacities were observed.

Conclusion

The results suggested that the insertion of an ICL brings about a change in the dynamics of the intraocular aqueous humour, reducing its circulation to the anterior surface of the crystalline lens. This is considered to cause a metabolic disturbance of the crystalline lens, resulting in anterior subcapsular opacification.

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Acknowledgement

The authors wish to express their thanks to Mr. C.W.P. Reynolds for linguistic assistance with the entire manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, School of Medicine, Kitasato University, 1-15-1 Kitasato, Sagamihara, Kanagawa, 228-8555, Japan

    Kunitoshi Fujisawa, Kimiya Shimizu, Masanobu Suzuki, Koichi Nagano, Yuuki Murakami & Hiroko Goseki

  2. Department of Orthoptic & Visual Science, School of Health Sciences, International University of Health and Welfare, Otawara, Tochigi, Japan

    Shigekazu Uga

Authors
  1. Kunitoshi Fujisawa
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  2. Kimiya Shimizu
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  3. Shigekazu Uga
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  4. Masanobu Suzuki
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  5. Koichi Nagano
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  6. Yuuki Murakami
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  7. Hiroko Goseki
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Correspondence to Kunitoshi Fujisawa.

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Fujisawa, K., Shimizu, K., Uga, S. et al. Changes in the crystalline lens resulting from insertion of a phakic IOL (ICL) into the porcine eye. Graefe's Arch Clin Exp Ophthalmol 245, 114–122 (2007). https://doi.org/10.1007/s00417-006-0338-y

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  • DOI: https://doi.org/10.1007/s00417-006-0338-y

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