title: Series of fibrinous inflammation after implantation of capsular tension rings.
abstract: OBJECTIVE
  To analyze the cause of fibrinous inflammation in eyes with capsular tension rings (CTRs) after cataract surgery.
  
  
  METHODS
  Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  High-performance liquid chromatography was implemented to eliminate impurities. One CTR was explanted for microbiologic examination. The pH values of the CTR and the storage solution were analyzed, Seldi and Maldi tests were performed, as well as toxicity tests with immortal cell lines. Material batches were analyzed. The organic carbon content of CTRs, detergents, and storage solutions was checked. The presence of endotoxins was excluded with the limulus amoebocyte lysate test. Gas chromatography with mass selective detector excluded the presence of extractable organic substances. An inductively coupled plasma analysis scanned for inorganic substances. The microbial count in operating rooms, smear tests, and microbiologic examinations of technical devices were initiated.
  
  
  RESULTS
  Analyses found no pathological findings. After intensive systemic and topical treatment with antibiotics and steroids, clinical findings improved. The implantation of CTRs was stopped immediately. No further cases occurred.
  
  
  CONCLUSIONS
  Fibrinous inflammations after implantation of CTRs were unknown until now. Contamination and/or irritation by detergents or the material CTR itself were excluded, indicating mechanical or toxic irritation by the CTR.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors: From the Department of Ophthalmology (Lorenz, Dick, Vetter, Stoffelns, Schoepfer, Korb, Pfeiffer) and Experimental Ophthalmology (Grus), University Medical Center, Johannes Gutenberg-University Mainz, Mainz, and the Center for Vision Science (Dick), Ruhr University Eye Hospital, Bochum, Germany. Electronic address: katrin.lorenz@unimedizin-mainz.de.
authors: Katrin
authors: K
authors: Lorenz
authors: From the Department of Ophthalmology (Lorenz, Dick, Vetter, Stoffelns, Schoepfer, Korb, Pfeiffer) and Experimental Ophthalmology (Grus), University Medical Center, Johannes Gutenberg-University Mainz, Mainz, and the Center for Vision Science (Dick), Ruhr University Eye Hospital, Bochum, Germany.
authors: H Burkhard
authors: HB
authors: Dick
authors: From the Department of Ophthalmology (Lorenz, Dick, Vetter, Stoffelns, Schoepfer, Korb, Pfeiffer) and Experimental Ophthalmology (Grus), University Medical Center, Johannes Gutenberg-University Mainz, Mainz, and the Center for Vision Science (Dick), Ruhr University Eye Hospital, Bochum, Germany.
authors: Franz
authors: F
authors: Grus
authors: From the Department of Ophthalmology (Lorenz, Dick, Vetter, Stoffelns, Schoepfer, Korb, Pfeiffer) and Experimental Ophthalmology (Grus), University Medical Center, Johannes Gutenberg-University Mainz, Mainz, and the Center for Vision Science (Dick), Ruhr University Eye Hospital, Bochum, Germany.
authors: Jan Markus
authors: JM
authors: Vetter
authors: From the Department of Ophthalmology (Lorenz, Dick, Vetter, Stoffelns, Schoepfer, Korb, Pfeiffer) and Experimental Ophthalmology (Grus), University Medical Center, Johannes Gutenberg-University Mainz, Mainz, and the Center for Vision Science (Dick), Ruhr University Eye Hospital, Bochum, Germany.
authors: Bernhard
authors: B
authors: Stoffelns
authors: From the Department of Ophthalmology (Lorenz, Dick, Vetter, Stoffelns, Schoepfer, Korb, Pfeiffer) and Experimental Ophthalmology (Grus), University Medical Center, Johannes Gutenberg-University Mainz, Mainz, and the Center for Vision Science (Dick), Ruhr University Eye Hospital, Bochum, Germany.
authors: Kilian
authors: K
authors: Schoepfer
authors: From the Department of Ophthalmology (Lorenz, Dick, Vetter, Stoffelns, Schoepfer, Korb, Pfeiffer) and Experimental Ophthalmology (Grus), University Medical Center, Johannes Gutenberg-University Mainz, Mainz, and the Center for Vision Science (Dick), Ruhr University Eye Hospital, Bochum, Germany.
authors: Christina
authors: C
authors: Korb
authors: From the Department of Ophthalmology (Lorenz, Dick, Vetter, Stoffelns, Schoepfer, Korb, Pfeiffer) and Experimental Ophthalmology (Grus), University Medical Center, Johannes Gutenberg-University Mainz, Mainz, and the Center for Vision Science (Dick), Ruhr University Eye Hospital, Bochum, Germany.
authors: Norbert
authors: N
authors: Pfeiffer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020878:Device Removal; D009877:Endophthalmitis / Q000209:etiology* / Q000378:metabolism; D005260:Female; D005337:Fibrin / Q000378:metabolism*; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008689:Methacrylates; D020366:Methylmethacrylate; D008875:Middle Aged; D018918:Phacoemulsification / Q000295:instrumentation*; D011183:Postoperative Complications; D019736:Prostheses and Implants / Q000009:adverse effects*; D019919:Prosthesis Implantation / Q000009:adverse effects*; D012189:Retrospective Studies
chemical_list: D008689:Methacrylates; D020366:Methylmethacrylate; C005044:hydroxyethyl methacrylate; D005337:Fibrin