AUTHOR=Ameku Kurt A. , Berggren Caleb C. , Pedrigi Ryan M. 

TITLE=Implantation of a capsular tension ring during cataract surgery attenuates predicted remodeling of the post-surgical lens capsule along the visual axis

JOURNAL=Frontiers in Bioengineering and Biotechnology

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/bioengineering-and-biotechnology/articles/10.3389/fbioe.2023.1300830

DOI=10.3389/fbioe.2023.1300830

ISSN=2296-4185

ABSTRACT=<p><bold>Introduction:</bold> Cataract surgery permanently alters the mechanical environment of the lens capsule by placing a hole in the anterior portion and implanting an intraocular lens (IOL) that has a very different geometry from the native lens. We hypothesized that implant configuration and mechanical interactions with the post-surgical lens capsule play a key role in determining long-term fibrotic remodeling.</p><p><bold>Methods:</bold> We developed the first finite element-growth and remodeling (FE-G&amp;R) model of the post-surgical lens capsule to evaluate how implantation of an IOL with and without a capsular tension ring (CTR) impacted evolving lens capsule mechanics and associated fibrosis over time after cataract surgery.</p><p><bold>Results:</bold> Our models predicted that implantation of a CTR with the IOL into the post-surgical lens capsule reduced the mechanical perturbation, thickening, and stiffening along the visual axis in both the remnant anterior and posterior portions compared to implantation of the IOL alone.</p><p><bold>Discussion:</bold> These findings align with patient studies and suggest that implantation of a CTR with the IOL during routine cataract surgery would attenuate the incidence of visually-debilitating capsule fibrosis. Our work demonstrates that use of such modeling techniques has substantial potential to aid in the design of better surgical strategies and implants.</p>