Kavita GalaDavid SpaltonJames BoyceAnish Dhital
ST THOMAS’S HOSPITAL, LONDON
No financial or proprietary interest
No financial or proprietary interest
INTRODUCTION
• Torsional fibrotic changes are sometimes seen in the anterior capsule following lens implantation
• Typically, these have a clockwise spiralling appearance
AIM
To study the evolution of spiralling changes and analyze their relation to patient factors
METHODS
• Retrospective study
• Screened 5000 images from our database of retroillumination images for eyes with typical spiralling
• The sequences of the images for each eye obtained
• For every image, the next non spiralling image from the database taken as control
• Images of the other eye extracted
METHODS • Changes in spiralling over time observed
• POCO software used to measure PCO
• POCOman software used to measure rhexis area
IOL power Capsulorrhexis size PCO percentage at 2 years
Compared to control eyes
Spiralling example 1PHP 22.0 SN60WF OD
3 MTHS
1 yr 2 YRS
3 YRS
Spiralling example 2BAB 22.5 Tecnis ZM001 OD
1 MTH
6 MTHS 3 YRS
3 YRS
Control eye exampleATO 23.5 OS SN60WF
1 MTH
3 MTHS
2 YRS
1 YR
RESULTS
0
2
4
6
8
10
12
14
16
spiralling
control
IOL distribution in each group
RESULTSAVERAGE SPIRALLING
GROUPCONTROL GROUP P VALUE
OD:OS 16:8 12:12 ns
PCO (% area) 3.92 ± 5.83 2.19 ± 3.13 ns
Rhexis diameter (mm)
4.14 ± 1.910 4.98 ± 2.36 <0.0001
IOL Power 21.260 ± 2.918 20.670 ± 2.319 ns
CONCLUSION
• Spiralling changes are caused due to torsional forces induced while dialling the lens into the bag due to the IOL binding with the bag
• Spiralling appears to be induced at surgery and then remains unchanged
• These changes are more commonly seen with a smaller rhexis- presumably because there is more contact between IOL and the bag.
