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Intraocular Lens Biocompatibility: A Novel, Objective Approach to Understanding Posterior Capsular Opacification.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Intraocular Lens Biocompatibility: A Novel, Objective Approach to Understanding Posterior Capsular Opacification./
作者:	Mastromonaco, Christina.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2017,
面頁冊數:	91 p.
附註:	Source: Masters Abstracts International, Volume: 82-09.
Contained By:	Masters Abstracts International82-09.
標題:	Biocompatibility. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28250436
ISBN:	9798582588467

Intraocular Lens Biocompatibility: A Novel, Objective Approach to Understanding Posterior Capsular Opacification.
Mastromonaco, Christina.

Intraocular Lens Biocompatibility: A Novel, Objective Approach to Understanding Posterior Capsular Opacification. - Ann Arbor : ProQuest Dissertations & Theses, 2017 - 91 p.

Source: Masters Abstracts International, Volume: 82-09.

Thesis (M.Sc.)--McGill University (Canada), 2017.

This item must not be sold to any third party vendors.

Posterior capsular opacification (PCO) is the leading complication following cataract surgery. Understanding factors that contribute to PCO development is a significant public concern as treatment can lead to complications. PCO depends on the biocompatibility of the patient and the artificial lens; known as an intraocular lens (IOL), implanted within the capsular bag of the eye after cataract surgery. In order to prevent PCO, a better understanding of IOL characteristics, including design and material, and how it interacts with patients is required. Herein, this study investigates three main objectives: to invent a new objective PCO quantification system in post-mortem eyes, to validate this methodology, and to perform a retrospective multivariable analysis to determine which factors (IOL and patientbased) are least likely to result in PCO. The ultimate goal is to find the optimum IOL platform for patients.In total, 180 post-mortem eyes with implanted IOLs were collected from the Minnesota Eye Bank, along with their clinical history, including date of cataract surgery and IOL model number. The capsular bag (CB) with the IOL implant was removed from all eyes to obtain digital images. PCO outcome was quantified on CB images using an objective, novel automated custom image analyzer. The software measured intensity and area of the opacification within the IOL optic edge, intraoptic edge (IOE= intensity/area), and the opacities found within the capsular bag just outwards of the IOL optic, known as Soemmering's ring (SR= intensity/area). Software-derived PCO outcomes were statistically analyzed with previously used subjective PCO grading to verify validity. Epidemiologic analysis determined which IOL characteristics and patient-related factors correlated with PCO. IOL factors included material, edge design, lens filter, decentration and time of IOL implantation. Patient factors included sex, age and diabetes mellitus, among others.The software PCO grading system correlated well with previous scoring methods. Multivariate analyses showed non-diabetic patients had less SR (P= 0.05). Individuals 50-80 years old compared to 80+ had lower SR PCO (P= 0.01). Square and frosted optic edge design had lower SR and IOE PCO rates compared to OptiEdge (P= 0.001, 0.03). Patients with an IOL implanted for less then 25 months had lower SR and IOE PCO. (P= 0.0001, 0.004).In order to generate a lens that does not develop PCO, it is critical to understand the IOL- and patient-related factors that lead to PCO development. Based on our data, the most susceptible patients are elderly and diabetic, and it may be preferable to implant a square and frosted edge lens.

ISBN: 9798582588467Subjects--Topical Terms:

656157
Biocompatibility.
Subjects--Index Terms:

Eye surgery

Intraocular Lens Biocompatibility: A Novel, Objective Approach to Understanding Posterior Capsular Opacification.
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245 1 0 $a Intraocular Lens Biocompatibility: A Novel, Objective Approach to Understanding Posterior Capsular Opacification.
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300 $a 91 p.
500 $a Source: Masters Abstracts International, Volume: 82-09.
500 $a Advisor: Burnier, Miguel Noel.
502 $a Thesis (M.Sc.)--McGill University (Canada), 2017.
506 $a This item must not be sold to any third party vendors.
520 $a Posterior capsular opacification (PCO) is the leading complication following cataract surgery. Understanding factors that contribute to PCO development is a significant public concern as treatment can lead to complications. PCO depends on the biocompatibility of the patient and the artificial lens; known as an intraocular lens (IOL), implanted within the capsular bag of the eye after cataract surgery. In order to prevent PCO, a better understanding of IOL characteristics, including design and material, and how it interacts with patients is required. Herein, this study investigates three main objectives: to invent a new objective PCO quantification system in post-mortem eyes, to validate this methodology, and to perform a retrospective multivariable analysis to determine which factors (IOL and patientbased) are least likely to result in PCO. The ultimate goal is to find the optimum IOL platform for patients.In total, 180 post-mortem eyes with implanted IOLs were collected from the Minnesota Eye Bank, along with their clinical history, including date of cataract surgery and IOL model number. The capsular bag (CB) with the IOL implant was removed from all eyes to obtain digital images. PCO outcome was quantified on CB images using an objective, novel automated custom image analyzer. The software measured intensity and area of the opacification within the IOL optic edge, intraoptic edge (IOE= intensity/area), and the opacities found within the capsular bag just outwards of the IOL optic, known as Soemmering's ring (SR= intensity/area). Software-derived PCO outcomes were statistically analyzed with previously used subjective PCO grading to verify validity. Epidemiologic analysis determined which IOL characteristics and patient-related factors correlated with PCO. IOL factors included material, edge design, lens filter, decentration and time of IOL implantation. Patient factors included sex, age and diabetes mellitus, among others.The software PCO grading system correlated well with previous scoring methods. Multivariate analyses showed non-diabetic patients had less SR (P= 0.05). Individuals 50-80 years old compared to 80+ had lower SR PCO (P= 0.01). Square and frosted optic edge design had lower SR and IOE PCO rates compared to OptiEdge (P= 0.001, 0.03). Patients with an IOL implanted for less then 25 months had lower SR and IOE PCO. (P= 0.0001, 0.004).In order to generate a lens that does not develop PCO, it is critical to understand the IOL- and patient-related factors that lead to PCO development. Based on our data, the most susceptible patients are elderly and diabetic, and it may be preferable to implant a square and frosted edge lens.
520 $a L'opacification capsulaire posterieure (OCP) est la principale complication apres une chirurgie de la cataracte. Les elements qui contribuent au developpement de l'OCP sont une preoccupation majeure du public car le traitement peut provoquer des complications. L'OCP depend de la biocompatibilite du patient envers la lentille artificielle; appelee lentille intraoculaire (LIO). Celle-ci est implantee dans le sac capsulaire, remplacant la lentille naturelle, apres une chirurgie de la cataracte. Afin de prevenir l'OCP, une meilleure comprehension des caracteristiques des LIO, comme le design, le materiel et l'interaction lentille-patient est necessaire. Cette etude observe trois objectifs principaux: creer un nouveau systeme de quantification objective de l'OCP dans les yeux obtenus post-mortem, valider cette methodologie en la comparant a la methode subjective, et realiser une analyse retrospective a plusieurs variables pour determiner quels sont les facteurs (LIO et patient) les moins susceptibles de causer l'OCP. Le but ultime est de trouver les caracteristiques optimales de LIO pour les patients.Au total, 180 yeux avec des LIO implantees ont ete recueillis post-mortem en provenance de la banque d'yeux du Minnesota, chacun comprenant l'historique clinique, la date de la chirurgie et le numero de modele de la LIO. Le sac capsulaire contenant l'implant LIO a ete preleve de chaque oeil pour en obtenir des images digitales. La presence d'OPC a ete quantifiee a partir des images de sac capsulaire a l'aide d'un logiciel d'analyse objective et automatise developpe dans le cadre de ce projet. Le logiciel mesure l'intensite et l'etendu de l'opacification du cote optique de la LIO, du cote intra-optique (BIO= intensite/zone), ainsi que les opacites dans le sac capsulaire juste a l'exterieur de la zone optique de la LIO, l'anneau de Soemmering (AS= Intensite/superficie). Les resultats d'OPC obtenu de facon automatise ont ensuite ete compares a l'ancienne methode d'evaluation subjective afin de verifier la validite du logiciel d'analyse. Les donnees epidemiologique ont ete evaluees afin de verifier le lien entre les proprietes de la LIO et en relation avec l'OCP. Les proprietes de la LIO incluent le materiel, le design, le filtre a lentille, la decentration et le temps d'implantation de la LIO. Enfin, les facteurs epidemiologiques incluent entres autres le sexe, l'age du patient et un diagnostic de diabete.Le systeme de classement de l'OCP du logiciel est en correlation avec les methodes de notation precedentes. Les analyses a plusieurs variables montrent que les patients non diabetiques ont moins d'opacites dans l'AS (P= 0.05). Les individus ages de 50 a 80 ans compares a ceux de 80 ans et plus ont une OCP infer ieure (P= 0.01). Les LIO avec un design a bordure optique carree et givree presente des taux d'OCP, AS et BIO inferieurs par rapport au design OptiEdge (P= 0.001, 0.03). Les patients qui ont une LIO implantee pour une duree inferieure a 25 mois ont une OCP AS et BIO plus faible. (P= 0.0001, 0.004).Afin de generer une lentille qui ne developpe pas d'OCP, il est essentiel de comprendre les elements de la LIO et les facteurs lies au patient qui menent au developpement de l'OCP. Sur la base de nos donnees, les patients les plus sensibles sont les personnes agees et les diabetiques; dans ces cas-ci, il peut etre preferable d'implanter une lentille a bordure carree et givree.
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650 4 $a Diabetes. $3 544344
650 4 $a Multivariate analysis. $3 517467
650 4 $a Peer review. $3 624199
650 4 $a Pathology. $3 643180
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650 4 $a Epidemiology. $3 568544
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