Polymer refilling of presbyopic human lenses in vitro restores the ability to undergo accommodative changes
Polymer refilling of presbyopic human lenses in vitro restores the ability to undergo accommodative changes
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DOI：
10.1167/iovs.02-0256
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发表时间：
2003-01-01
影响因子：
4.4
通讯作者：
Kooijman, AC
中科院分区：
文献类型：
--
作者：
Koopmans, SA;Terwee, B;Kooijman, AC
目的.因为老视被认为伴随着增加的透镜硬化，所以进行该研究以调查用软聚合物重新填充老视人透镜的囊是否将恢复透镜经历变性变化的能力。通过睫状体和小带复合体的周向拉伸，对天然晶状体和再填充晶状体施加反作用力。研究了9个天然晶状体和10个来自17至60岁供体的再填充晶状体。使用具有不同杨氏模量的两种再填充聚合物。通过扫描激光光线跟踪技术测量透镜屈光度，并同时测量透镜直径和透镜厚度，同时通过睫状体上的向外牵拉逐步增加悬韧带上的张力。在天然晶状体中，较旧的晶状体不能随着睫状体的拉伸而发生屈光度变化，而在再填充晶状体中，所有晶状体显示出与年轻的天然晶状体相当的屈光度变化。重新填充的人类晶状体比年龄匹配的天然晶状体具有更高的透镜屈光度。当睫状体直径增加4 Him时，聚合物的杨氏模量影响透镜屈光度的变化。用软聚合物重新填充老视镜片能够通过机械拉伸恢复透镜屈光力变化。因为透镜的硬化是人类老视的重要因素，所以在白内障的透镜手术期间重新填充透镜可以使人类老视恢复清晰的视觉和调节。
PURPOSE. Because presbyopia is thought to be accompanied by increased lens sclerosis this study was conducted to investigate whether refilling the capsule of the presbyopic human lens with a soft polymer would restore the ability of the lens to undergo accommodative changes.METHODS. Accommodative forces were applied to natural and refilled lenses by circumferential stretching through the ciliary body and zonular complex. Nine natural lenses and 10 refilled lenses from donors ranging in age from 17 to 60 years were studied. Two refill polymers with a different Young's modulus were used. The lens power was measured by a scanning laser ray-tracing technique, and lens diameter and lens thickness were measured simultaneously while the tension on the zonules was increased stepwise by outward pull on the ciliary body.RESULTS. In the natural lenses the older lenses were not able to undergo power changes with stretching of the ciliary body, whereas in the refilled lenses, all lenses showed power changes comparable to young, natural lenses. The refilled human lenses had a higher lens power than the age-matched natural lenses. The Young's modulus of the polymers influenced the lens power change when measured with the ciliary body diameter increased by 4 Him.CONCLUSIONS. Refilling presbyopic lenses with a soft polymer enabled restoration of lens power changes with mechanical stretching. Because sclerosis of the lens is an important factor in human presbyopia, refilling the lens during lens surgery for cataract could enable restoration of clear vision and accommodation in human presbyopia.