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.