LENS REFILLING AND ENDOCAPSULAR POLYMERIZATION OF AN INJECTABLE INTRAOCULAR-LENS - IN-VITRO AND IN-VIVO STUDY OF POTENTIAL RISKS AND BENEFITS

Endocapsular cataract removal and injection of a liquid artificial len s has several advantages, including restitution of accommodation, smal l corneoscleral incision, a more physiological position of the intraoc ular lens, and a reduced rate of secondary opacification. Our techniqu e consists of bimanual phacofragmentation followed by injection of a f luid monomeric material that can be polymerized inside the capsular ba g by short light exposure. Our study assessed the potential risks of t he technique (e.g., heat damage to ocular tissue, light damage to the retina) and investigated the technique in vivo. We performed in vitro experiments on porcine cadaver eyes and an in vivo study on 1 5 rabbit s. After a clinical follow-up of at least 12 weeks, the eyes were inve stigated histopathologically. During the polymerization process, the h ighest temperature measured at the posterior lens capsule was 45.1 deg rees Celsius for a few seconds. The measured irradiance (0.065 watts p er cm2) and the risk of photochemical damage to the retina during 20 s econds of polymerization were comparable to that caused by 1.5 minutes of standard coaxial illumination with the operating microscope. In vi vo there were no serious inflammatory reactions except in four Gases i n which there had been intraoperative problems. The rate of secondary opacification appeared less than in conventional intraocular lens impl antation in rabbits, especially when the capsule refilled completely. Retinal damage could not be detected histopathologically. In conclusio n, refilling techniques may be successful once appropriate refilling m aterials become available.