Series of fibrinous inflammation after implantation of capsular tension rings

Abstract

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.