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      Influence of Lens Power on IOL/Posterior Lens Capsule Interactions and IOL's PCO Potential

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          Abstract

          Purpose

          Severely myopic eyes have been associated with high posterior capsule opacification (PCO) incidence. Although it has been reported that myopic eyes have weaker or more delayed capsule adhesion than emmetropic eyes, it is unclear whether/how dioptric power and posterior curvature of IOLs affect IOLs’ affinity for the posterior lens capsule (PLC) and their PCO potential.

          Methods

          To investigate this, acrylic foldable IOLs with increasing dioptric power of 6.0D (for high myopia), 20.0D, and 30.0D (for low/non-myopia) were tested on their binding affinity toward PLC and their ability to inhibit the proliferation and infiltration of lens epithelial cells (LECs) using an in vitro simulated human PLC (sPLC) model.

          Results

          We found that IOL power and posterior radius of curvature (PRC) had significant impacts on IOL/sPLC adhesion forces, which are in the following order: 20.0D ≈ 30.0D > 6.0D. Optical coherence tomography (OCT) images showed that loose binding between 6.0D IOLs and sPLC contributed to larger interface spaces and significantly greater LEC infiltration, proliferation, metabolic activity, and transdifferentiation compared to 20.0D and 30.0D IOLs. Statistical analyses showed that IOLs’ PRC may have a substantial influence on IOL/sPLC physical interactions, LEC responses, and PCO incidence.

          Conclusions

          The overall results suggest that the high PRC of low-diopter (6.0D) IOLs reduces their binding affinity toward the PLC, facilitates LEC reactions, thus causes high PCO incidence in myopic eyes. These findings strongly support that a new design to increase IOL posterior surfaces’ PLC affinity may reduce PCO potential and increase safety for myopic patients.

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          Most cited references66

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          Correlation Coefficients

          Correlation in the broadest sense is a measure of an association between variables. In correlated data, the change in the magnitude of 1 variable is associated with a change in the magnitude of another variable, either in the same (positive correlation) or in the opposite (negative correlation) direction. Most often, the term correlation is used in the context of a linear relationship between 2 continuous variables and expressed as Pearson product-moment correlation. The Pearson correlation coefficient is typically used for jointly normally distributed data (data that follow a bivariate normal distribution). For nonnormally distributed continuous data, for ordinal data, or for data with relevant outliers, a Spearman rank correlation can be used as a measure of a monotonic association. Both correlation coefficients are scaled such that they range from -1 to +1, where 0 indicates that there is no linear or monotonic association, and the relationship gets stronger and ultimately approaches a straight line (Pearson correlation) or a constantly increasing or decreasing curve (Spearman correlation) as the coefficient approaches an absolute value of 1. Hypothesis tests and confidence intervals can be used to address the statistical significance of the results and to estimate the strength of the relationship in the population from which the data were sampled. The aim of this tutorial is to guide researchers and clinicians in the appropriate use and interpretation of correlation coefficients.
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            Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050.

            Myopia is a common cause of vision loss, with uncorrected myopia the leading cause of distance vision impairment globally. Individual studies show variations in the prevalence of myopia and high myopia between regions and ethnic groups, and there continues to be uncertainty regarding increasing prevalence of myopia.
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              The epidemics of myopia: Aetiology and prevention.

              There is an epidemic of myopia in East and Southeast Asia, with the prevalence of myopia in young adults around 80-90%, and an accompanying high prevalence of high myopia in young adults (10-20%). This may foreshadow an increase in low vision and blindness due to pathological myopia. These two epidemics are linked, since the increasingly early onset of myopia, combined with high progression rates, naturally generates an epidemic of high myopia, with high prevalences of "acquired" high myopia appearing around the age of 11-13. The major risk factors identified are intensive education, and limited time outdoors. The localization of the epidemic appears to be due to the high educational pressures and limited time outdoors in the region, rather than to genetically elevated sensitivity to these factors. Causality has been demonstrated in the case of time outdoors through randomized clinical trials in which increased time outdoors in schools has prevented the onset of myopia. In the case of educational pressures, evidence of causality comes from the high prevalence of myopia and high myopia in Jewish boys attending Orthodox schools in Israel compared to their sisters attending religious schools, and boys and girls attending secular schools. Combining increased time outdoors in schools, to slow the onset of myopia, with clinical methods for slowing myopic progression, should lead to the control of this epidemic, which would otherwise pose a major health challenge. Reforms to the organization of school systems to reduce intense early competition for accelerated learning pathways may also be important.
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                Author and article information

                Journal
                Invest Ophthalmol Vis Sci
                Invest Ophthalmol Vis Sci
                IOVS
                Investigative Ophthalmology & Visual Science
                The Association for Research in Vision and Ophthalmology
                0146-0404
                1552-5783
                17 January 2025
                January 2025
                : 66
                : 1
                : 41
                Affiliations
                [1 ]Department of Bioengineering, University of Texas at Arlington, Arlington, Texas, United States
                Author notes
                [# ]Correspondence: Liping Tang, Department of Bioengineering, University of Texas at Arlington, P.O. Box 19138, Arlington, TX 76019-0138, USA; ltang@ 123456uta.edu .
                [*]

                AC and VE contributed equally.

                Article
                IOVS-24-41275
                10.1167/iovs.66.1.41
                11753477
                39820279
                f9831d7d-3122-42b5-a7ed-a60446a3a24e
                Copyright 2025 The Authors

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 20 December 2024
                : 05 September 2024
                Page count
                Pages: 9
                Categories
                Lens
                Lens

                myopia,pco,intraocular lens,iol dioptric power,posterior lens capsule,adhesion force,lens epithelial cells,in vitro model

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