Bag-in-the-lens implantation of intraocular lenses.
OBJECTIVE
To report a new intraocular lens (IOL) and an IOL implantation concept, the bag-in-the-lens implantation technique, designed to prevent posterior capsule opacification (PCO).


METHODS
The University of Antwerp, Department of Ophthalmology, Edegem, Belgium, and the Netherlands Ophthalmic Research Institute, Department of Morphology, Amsterdam, The Netherlands.


METHODS
After identical curvilinear capsulorhexes are created in both the anterior and posterior capsules, the capsules are inserted in a flange of the IOL, thus the term bag-in-the-lensas opposed to the currently used lens-in-the-bagtechnique. The IOL was implanted in an in vitro human capsular bag model and in 10 eyes of 9 patients with cataract. Lens epithelial cell (LEC) outgrowth and PCO formation were observed.


RESULTS
When both capsular blades were well stretched around the IOL optic, the in vitro capsular bag model showed LEC proliferation only within the space of the remaining lens bag. The LEC proliferation was limited, and there was no tendency toward proliferation approaching the visual axis. In all 10 eyes, the optical axis remained clear during a follow-up between 4 and 15 months.


CONCLUSIONS
This new IOL prevented LEC proliferation in vitro and seems promising in vivo. Target patients are those at risk of PCO including those with congenital cataract, uveitis, diabetes, or cataract extraction combined with vitrectomy.
Tassignon
Marie-José B R
MJ
Department of Ophthalmology, University of Antwerp, (Tassignon, De Groot), Edegem, Belgium. marie-jose.tassignon@uza.be
De Groot
Veva
V
Vrensen
Gijs F J M
GF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D019923:Capsulorhexis; D002386:Cataract / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods*; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011102:Polyhydroxyethyl Methacrylate; D011183:Postoperative Complications / Q000517:prevention & control; D011474:Prosthesis Design; D014792:Visual Acuity
D001672:Biocompatible Materials; D011102:Polyhydroxyethyl Methacrylate