Effect of anterior capsule polishing on the posterior capsule opacification–inhibiting properties of a sharp-edged, 3-piece, silicone intraocular lens

Abstract

Three years after cataract surgery, eyes in which the anterior capsule had been polished had significantly less ACO. However, polishing did not lower PCO intensity when a sharp-edged CeeOn 911A IOL was implanted in the bag. Although results indicate that anterior capsule polishing may enhance the development of regeneratory PCO, this trend did not reach statistical significance.

Impact of anterior capsule polishing on anterior capsule opacification after cataract surgery: a randomized clinical trial

“…Menapace and collegues 3 have found that ACO rates are significantly lower in polished eyes compared with unpolished eyes at all follow-up examinations. Sacu et al 2 found that although careful anterior capsule polishing reduces ACO and fibrotic PCO, neither can be completely prevented.…”

“…1 Despite recent progress in cataract extraction techniques, lens implantation techniques, and IOL design, capsular opacification still remains a problem. [2][3][4] Capsular opacification takes place due to proliferation, migration, and differentiation of residual lens epithelial cells (LECs). 5 These LECs attempt to undergo normal differentiation or epithelial mesenchymal transition (EMT), and consequently form heterogeneous groups of cells in the anterior capsule opacification (ACO) and posterior capsule opacification (PCO).…”

“…6 Contact with the IOL optic causes the LECs of the anterior capsule to undergo fibrosis, resulting in fibrotic type of ACO. 3,4,[7][8][9][10] Fibrosis of the anterior capsule leads to contraction of the capsulorhexis opening or capsule retraction leading to buttonholing of the lens optic and reduction in the free optic zone. The latter may cause decentration of the IOL optic and fibrotic opacification of the posterior capsule.…”

Effect of Anterior Capsule Polishing on the Need for Laser Capsulotomy

“…A study by Nishi and Nishi found that mechanical intraoperative anterior capsule polishing (ACP) reduces the rate by 7.1% [10]. However, other studies challenge those findings and conclude that changes in surgical technique, such as capsule polishing, fail to prevent PCO [11] [12] [13] [14] [15], although a capsulorhexis size that lies on the optic diameter appears to be beneficial [16]. Moreover, capsular polishing is reported to exacerbate PCO, as found in the long-term follow-up studies [11] [12] [13].…”

“…However, other studies challenge those findings and conclude that changes in surgical technique, such as capsule polishing, fail to prevent PCO [11] [12] [13] [14] [15], although a capsulorhexis size that lies on the optic diameter appears to be beneficial [16]. Moreover, capsular polishing is reported to exacerbate PCO, as found in the long-term follow-up studies [11] [12] [13]. In recent years, with the development and rising popularity of new generation of premium (IOLs) like the multifocal, toric, accommodative, the clinical significance of the LEC removal may become more important when a maximum optical zone is required (e.g., multifocal IOLS) [5].…”