Repositioning and scleral fixation of the subluxated lens capsule using an intraocular anchoring device in experimental models.
OBJECTIVE
To describe a new device for repositioning and scleral fixation of the capsular bag of subluxated lenses in experimental models.


METHODS
Laboratory for Experimental Microsurgery, Meir Medical Center, Kfar-Saba, Israel.


METHODS
The capsular anchoring device is a poly(methyl methacrylate) 1-plane implant consisting of 2 handles that grasp the edges of the capsulorhexis and a base for scleral fixation with a single 10-0 or 9-0 polypropylene suture. A temporary safety suture can be used to facilitate manipulations and prevent loss of the device through the zonular defect until it is secured to the scleral wall. The device was implanted in porcine eyes and living rabbit eyes. An animal model of lens subluxation was achieved by tearing about one third of the zonules. Capsule centration, implant stability, and inflammatory reaction were evaluated 2 to 4 weeks after implantation in the living model.


RESULTS
The device was implanted in 7 porcine eyes and 9 living rabbit eyes. A lens subluxation model was created in 4 porcine eyes and 2 rabbit eyes. The device effectively pulled the capsular bag to the center and remained stable up to 4 weeks thereafter. Very large zonular dialysis (>5 hours) was managed using 2 devices. Successful intraocular lens implantation was done repeatedly in the presence of the device. The implant was well tolerated in all rabbit eyes. Histopathological examination of the enucleated eyes revealed no inflammatory reaction or adhesions. The margin of the anterior capsulorhexis remained intact in all cases.


CONCLUSIONS
Experimental studies of a capsular anchoring device for subluxated lenses confirmed the safety and efficacy of the new device. A capsular tension ring can also be inserted separately to further stabilize the capsular bag.
Ton
Yokrat
Y
Meir Medical Center, Kfar-Saba, Israel.
Michaeli
Adi
A
Assia
Ehud I
EI
D000818:Animals; D002387:Cataract Extraction / Q000295:instrumentation*; D004195:Disease Models, Animal; D007903:Lens Capsule, Crystalline / Q000601:surgery*; D007906:Lens Subluxation / Q000601:surgery*; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D011474:Prosthesis Design; D011817:Rabbits; D012590:Sclera / Q000601:surgery*; D013536:Suture Techniques; D013552:Swine
D019904:Polymethyl Methacrylate