Eintrübung hydrophiler Acrylintraokularlinsen: Überblick zu Labormethoden der histologischen Analyse und Replikation der Kalzifikation

Zusammenfassung

Eintrübungen von Acryllinsen durch Materialveränderungen stellen schwerwiegende Komplikationen dar, welche die sehr guten postoperativen Visusergebnisse unkomplizierter Kataraktoperationen gefährden. Für hydrophobe Acryllinsen besteht die Möglichkeit einer Bildung von Glistenings, bei hydrophilen Acryllinsen besteht das Risiko einer Kalzifikation durch Kalziumphosphate. Im Laufe der Zeit wurden verschiedene Methoden entwickelt, um die Eintrübungen hydrophiler Acryllinsen zu untersuchen. Ziel der vorliegenden Arbeit ist eine Methodenübersicht über die histologischen Standardfärbungen und Möglichkeiten der Replikation einer IOL-Kalzifikation. Mittels histologischer Färbungen lässt sich die Kalzifikation von Eintrübungen anderer Art differenzieren und die Ausprägung der Kalzifikation beurteilen. Durch die Entwicklung von In-vivo- und In-vitro-Modellen zur Replikation konnten der Kalzifikation zugrunde liegende Pathomechanismen identifiziert werden. In-vivo-Modelle eignen sich zur Beurteilung der Biokompatibilität verwendeter Linsenmaterialien. Mithilfe eines In-vitro-Modells in Bioreaktoren kann die Kinetik der Kristallbildung untersucht werden. Die Verwendung einer Elektrophorese zur Replikation der Kalzifikation unter standardisierten Bedingungen erlaubt einen Vergleich verschiedener Linsenmaterialien bezüglich des Kalzifikationsrisikos. Die Kombination verschiedener Analyse- und Replikationsmethoden kann in Zukunft dazu verwendet werden, die Pathomechanismen der Kalziumphosphatbildung und den Zusammenhang zu Risikofaktoren näher zu untersuchen. Dies könnte dazu beitragen, die Kalzifikation hydrophiler Acryllinsen und damit einhergehende Explantationen und Komplikationen zu vermeiden.

Schlüsselwörter

IOL-Kalzifikation - Eintrübung - Komplikation - Kataraktchirurgie - Histologie

Publication History

Received: 30 January 2023

Accepted: 29 March 2023

Article published online:
30 June 2023

• References/Literatur

• 1 Grzybowski A. Recent developments in cataract surgery. Ann Transl Med 2020; 8: 1540 DOI: 10.21037/atm-2020-rcs-16.
• 2 Khoramnia R, Yildirim TM, Labuz G. et al. [Opacification of intraocular lenses: laboratory and clinical findings]. Ophthalmologe 2021; 118: 633-642 DOI: 10.1007/s00347-020-01259-3.
• 3 Labuz G, Knebel D, Auffarth GU. et al. Glistening Formation and Light Scattering in Six Hydrophobic-Acrylic Intraocular Lenses. Am J Ophthalmol 2018; 196: 112-120 DOI: 10.1016/j.ajo.2018.08.032.
• 4 Yildirim TM, Auffarth GU, Labuz G. et al. Material Analysis and Optical Quality Assessment of Opacified Hydrophilic Acrylic Intraocular Lenses After Pars Plana Vitrectomy. Am J Ophthalmol 2018; 193: 10-19 DOI: 10.1016/j.ajo.2018.06.002.
• 5 Giers BC, Tandogan T, Auffarth GU. et al. Hydrophilic intraocular lens opacification after posterior lamellar keratoplasty – a material analysis with special reference to optical quality assessment. BMC Ophthalmol 2017; 17: 150 DOI: 10.1186/s12886-017-0546-8.
• 6 Kanclerz P, Yildirim TM, Khoramnia R. Microscopic Characteristics of Late Intraocular Lens Opacifications. Arch Pathol Lab Med 2021; 145: 759-767 DOI: 10.5858/arpa.2019-0626-RA.
• 7 Kanclerz P, Yildirim TM, Khoramnia R. A review of late intraocular lens opacifications. Curr Opin Ophthalmol 2021; 32: 31-44 DOI: 10.1097/ICU.0000000000000719.
• 8 Drimtzias EG, Rokidi SG, Gartaganis SP. et al. Experimental investigation on mechanism of hydrophilic acrylic intraocular lens calcification. Am J Ophthalmol 2011; 152: 824-833.1 DOI: 10.1016/j.ajo.2011.04.009.
• 9 Gartaganis SP, Prahs P, Lazari ED. et al. Calcification of Hydrophilic Acrylic Intraocular Lenses With a Hydrophobic Surface: Laboratory Analysis of 6 Cases. Am J Ophthalmol 2016; 168: 68-77 DOI: 10.1016/j.ajo.2016.04.018.
• 10 Labuz G, Yildirim TM, van den Berg T. et al. Assessment of straylight and the modulation transfer function of intraocular lenses with centrally localized opacification associated with the intraocular injection of gas. J Cataract Refract Surg 2018; 44: 615-622 DOI: 10.1016/j.jcrs.2018.01.033.
• 11 Yildirim TM, Labuz G, Khoramnia R. et al. Impact of Primary Calcification in Segmented Refractive Bifocal Intraocular Lenses on Optical Performance Including Straylight. J Refract Surg 2020; 36: 20-27 DOI: 10.3928/1081597X-20191119-01.
• 12 Neuhann T, Yildirim TM, Son HS. et al. Reasons for explantation, demographics, and material analysis of 200 intraocular lens explants. J Cataract Refract Surg 2020; 46: 20-26 DOI: 10.1016/j.jcrs.2019.08.045.
• 13 Fernandez-Buenaga R, Alio JL. Intraocular Lens Explantation After Cataract Surgery: Indications, Results, and Explantation Techniques. Asia Pac J Ophthalmol (Phila) 2017; 6: 372-380 DOI: 10.22608/APO.2017181.
• 14 Leysen I, Bartholomeeusen E, Coeckelbergh T. et al. Surgical outcomes of intraocular lens exchange: five-year study. J Cataract Refract Surg 2009; 35: 1013-1018 DOI: 10.1016/j.jcrs.2009.01.024.
• 15 Yildirim TM, Khoramnia R, Schickhardt SK. et al. Variation in intraocular lens calcification under different environmental conditions in eyes with supplementary sulcus-supported lenses. Am J Ophthalmol Case Rep 2020; 19: 100797 DOI: 10.1016/j.ajoc.2020.100797.
• 16 Khoramnia R, Salgado JP, Auffarth GU. et al. [Opacification of a hydrophilic intraocular lens 4 years after cataract surgery. A biomaterial analysis]. Ophthalmologe 2012; 109: 483-486 DOI: 10.1007/s00347-011-2487-6.
• 17 Tandogan T, Khoramnia R, Choi CY. et al. Optical and material analysis of opacified hydrophilic intraocular lenses after explantation: a laboratory study. BMC Ophthalmol 2015; 15: 170 DOI: 10.1186/s12886-015-0149-1.
• 18 Werner L, Apple DJ, Escobar-Gomez M. et al. Postoperative deposition of calcium on the surfaces of a hydrogel intraocular lens. Ophthalmology 2000; 107: 2179-2185 DOI: 10.1016/s0161-6420(00)00416-4.
• 19 Khoramnia R, Yildirim TM, Labuz G. et al. [Opacification of intraocular lenses: laboratory and clinical findings]. Ophthalmologe 2021; 118: 633-642 DOI: 10.1007/s00347-020-01259-3.
• 20 Schrittenlocher S, Penier M, Schaub F. et al. Intraocular Lens Calcifications After (Triple-) Descemet Membrane Endothelial Keratoplasty. Am J Ophthalmol 2017; 179: 129-136 DOI: 10.1016/j.ajo.2017.04.024.
• 21 Marcovich AL, Tandogan T, Bareket M. et al. Opacification of hydrophilic intraocular lenses associated with vitrectomy and injection of intraocular gas. BMJ Open Ophthalmol 2018; 3: e000157 DOI: 10.1136/bmjophth-2018-000157.
• 22 Mulisch M, Welsch U. Romeis – Mikroskopische Technik. Heidelberg: Springer Spektrum Berlin, Heidelberg;; 2015
• 23 Gartaganis SP, Kanellopoulou DG, Mela EK. et al. Opacification of hydrophilic acrylic intraocular lens attributable to calcification: investigation on mechanism. Am J Ophthalmol 2008; 146: 395-403 DOI: 10.1016/j.ajo.2008.04.032.
• 24 Buchen SY, Cunanan CM, Gwon A. et al. Assessing intraocular lens calcification in an animal model. J Cataract Refract Surg 2001; 27: 1473-1484 DOI: 10.1016/s0886-3350(01)00842-2.
• 25 Britz L, Schickhardt SK, Yildirim TM. et al. Development of a standardized in vitro model to reproduce hydrophilic acrylic intraocular lens calcification. Sci Rep 2022; 12: 7685 DOI: 10.1038/s41598-022-11486-0.
• 26 Britz L, Schickhardt SK, Yildirim TM. et al. [Hydrophobic surface properties of hydrophilic acrylic lenses do not protect against calcification]. Ophthalmologie 2023; DOI: 10.1007/s00347-023-01862-0.
• 27 Abdalla Elsayed MEA, Ahmad K, Al-Abdullah AA. et al. Incidence of Intraocular Lens Exchange after Cataract Surgery. Sci Rep 2019; 9: 12877 DOI: 10.1038/s41598-019-49030-2.
• 28 Kristianslund O, Raen M, Ostern AE. et al. Late In-the-Bag Intraocular Lens Dislocation: A Randomized Clinical Trial Comparing Lens Repositioning and Lens Exchange. Ophthalmology 2017; 124: 151-159 DOI: 10.1016/j.ophtha.2016.10.024.
• 29 Hayashi K, Hirata A, Hayashi H. Possible predisposing factors for in-the-bag and out-of-the-bag intraocular lens dislocation and outcomes of intraocular lens exchange surgery. Ophthalmology 2007; 114: 969-975 DOI: 10.1016/j.ophtha.2006.09.017.
• 30 Dalby M, Kristianslund O, Drolsum L. Long-Term Outcomes after Surgery for Late In-The-Bag Intraocular Lens Dislocation: A Randomized Clinical Trial. Am J Ophthalmol 2019; 207: 184-194 DOI: 10.1016/j.ajo.2019.05.030.
• 31 Fernandez-Buenaga R, Alio JL, Perez-Ardoy AL. et al. Late in-the-bag intraocular lens dislocation requiring explantation: risk factors and outcomes. Eye (Lond) 2013; 27: 795-801 DOI: 10.1038/eye.2013.95.
• 32 Kristianslund O, Dalby M, Drolsum L. Late in-the-bag intraocular lens dislocation. J Cataract Refract Surg 2021; 47: 942-954 DOI: 10.1097/j.jcrs.0000000000000605.
• 33 Lyle WA, Jin JC. An analysis of intraocular lens exchange. Ophthalmic Surg 1992; 23: 453-458
• 34 Balasubramaniam C, Goodfellow J, Price N. et al. Opacification of the Hydroview H60 M intraocular lens: total patient recall. J Cataract Refract Surg 2006; 32: 944-948 DOI: 10.1016/j.jcrs.2006.02.047.
• 35 Neuhann IM, Kleinmann G, Apple DJ. A new classification of calcification of intraocular lenses. Ophthalmology 2008; 115: 73-79 DOI: 10.1016/j.ophtha.2007.02.016.
• 36 Sher JH, Gooi P, Dubinski W. et al. Comparison of the incidence of opacification of Hydroview hydrogel intraocular lenses with the ophthalmic viscosurgical device used during surgery. J Cataract Refract Surg 2008; 34: 459-464 DOI: 10.1016/j.jcrs.2007.10.029.
• 37 Werner L. Causes of intraocular lens opacification or discoloration. J Cataract Refract Surg 2007; 33: 713-726 DOI: 10.1016/j.jcrs.2007.01.015.
• 38 Lin SY, Chen KH, Li MJ. et al. Evidence of octacalcium phosphate and type-B carbonated apatites deposited on the surface of explanted acrylic hydrogel intraocular lens. J Biomed Mater Res B Appl Biomater 2004; 70: 203-208 DOI: 10.1002/jbm.b.30067.
• 39 Costa JF, Bompastor-Ramos P, Marques M. et al. Large-scale opacification of a hydrophilic/hydrophobic intraocular lens. Eur J Ophthalmol 2020; 30: 307-314 DOI: 10.1177/1120672119830581.
• 40 Oculentis. Field Safety Notice: Recall Lentis foldable Intraocular lenses. 2017-09-12. Im Internet (Stand: 10.05.2023): https://www.bfarm.de/SharedDocs/Kundeninfos/EN/11/2017/09163-17_kundeninfo_en.pdf?__blob=publicationFile&v=1
• 41 Scherer NCD, Müller K, Prahs PM. et al. Serial opacification of a hydrophilic-hydrophobic acrylic intraocular lens: analysis of potential risk factors. J Cataract Refract Surg 2020; 46: 1624-1629 DOI: 10.1097/j.jcrs.0000000000000342.
• 42 Kim CJ, Choi SK. Analysis of aqueous humor calcium and phosphate from cataract eyes with and without diabetes mellitus. Korean J Ophthalmol 2007; 21: 90-94 DOI: 10.3341/kjo.2007.21.2.90.
• 43 Fung SS, Sykakis E, Islam NM. et al. Intraocular Lens Opacification following Intracameral Injection of Recombinant Tissue Plasminogen Activator to Treat Inflammatory Membranes after Cataract Surgery. J Ophthalmol 2015; 2015: 975075 DOI: 10.1155/2015/975075.
• 44 Darcy K, Apel A, Donaldson M. et al. Calcification of hydrophilic acrylic intraocular lenses following secondary surgical procedures in the anterior and posterior segments. Br J Ophthalmol 2019; 103: 1700-1703 DOI: 10.1136/bjophthalmol-2018-313385.
• 45 Roland S, Khoramnia R, Auffarth GU. et al. [Opacification of hydrophilic intraocular lens after multiple injections of bevacizumab]. Ophthalmologe 2019; 116: 882-886 DOI: 10.1007/s00347-018-0829-3.
• 46 Giers BC, Khoramnia R, Tandogan T. et al. [Liquefied Aftercataract Mimicking IOL-Opacification]. Klin Monbl Augenheilkd 2017; 234: 988-990 DOI: 10.1055/s-0042-121808.
• 47 Dagres E, Khan MA, Kyle GM. et al. Perioperative complications of intraocular lens exchange in patients with opacified Aqua-Sense lenses. J Cataract Refract Surg 2004; 30: 2569-2573 DOI: 10.1016/j.jcrs.2004.04.055.
• 48 Dey A, Bomans PH, Müller FA. et al. The role of prenucleation clusters in surface-induced calcium phosphate crystallization. Nat Mater 2010; 9: 1010-1014 DOI: 10.1038/nmat2900.
• 49 Kimura K, Kamitakahara M, Yokoi T. et al. Formation Process of Hydroxyapatite Granules in Agarose Hydrogel by Electrophoresis. Cryst Growth Des 2018; 18: 1961-1966 DOI: 10.1021/acs.cgc1.7b01154.
• 50 Fernandez J, Sanchez-Garcia A, Rodriguez-Vallejo M. et al. Systematic review of potential causes of intraocular lens opacification. Clin Exp Ophthalmol 2020; 48: 89-97 DOI: 10.1111/ceo.13650.
• 51 Johnson III JR, Meng l Wnek GE. et al. Electrophoretic calcium phosphate mineralization of collagen hydrogels. Green Materials 2015; 3: 71-79 DOI: 10.1680/jgrma.15.00007.
• 52 Watanabe J, Akashi M. Novel biomineralization for hydrogels: electrophoresis approach accelerates hydroxyapatite formation in hydrogels. Biomacromolecules 2006; 7: 3008-3011 DOI: 10.1021/bm060488h.
• 53 Zainuddin. Hill DJT, Whittaker AK. et al. Preferential interactions of calcium ions in poly(2-hydroxyethyl methacrylate) hydrogels. J Mater Sci Mater Med 2007; 18: 1141-1149 DOI: 10.1007/s10856-007-0135-0.
• 54 Dalas E, Kallitsis JK, Koutsoukos PG. Crystallization of Hydroxyapatite on Polymers. Langmuir 1991; 7: 1822-1826 DOI: 10.1021/la00056a040.