6533b838fe1ef96bd12a5229

RESEARCH PRODUCT

Series of fibrinous inflammation after implantation of capsular tension rings

H. Burkhard DickKatrin LorenzChristina KorbNorbert PfeifferBernhard M. StoffelnsJan M. VetterKilian SchoepferFranz H. Grus

subject

Malemedicine.medical_specialtyAfter cataractTopical treatmentMethylmethacrylatemedicine.disease_causeProsthesis ImplantationPostoperative ComplicationsLens Implantation IntraocularOphthalmologymedicineHumansUniversity medicalDevice RemovalAgedRetrospective StudiesAged 80 and overEndophthalmitisFibrinPhacoemulsificationAmoebocyte lysatebusiness.industrySmear testsFibrinous inflammationProstheses and ImplantsMiddle AgedSensory SystemsSurgeryOphthalmologyMethacrylatesFemaleSurgeryIrritationbusiness

description

Purpose To analyze the cause of fibrinous inflammation in eyes with capsular tension rings (CTRs) after cataract surgery. Setting Department of Ophthalmology, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany. Design 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. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

https://doi.org/10.1016/j.jcrs.2013.07.041