Effect of intraocular lens design on posterior capsule opacification after continuous curvilinear capsulorhexis

Abstract

We compared the effect of biconvex and convex-plano (posterior plano) intraocular lenses on posterior capsule opacification (PCO) following continuous curvilinear capsulorhexis (CCC) in 212 eyes. During the three years following surgery, the cumulative frequency of neodymium:YAG laser posterior capsulotomy, calculated with the Kaplan-Meier method, was significantly higher in patients in the biconvex group (32.5% by the third year) than in those in the convex-plano group (5.9% by the third year) (P < .05, Wilcoxon's test; P < .01, Cox-Mantel's test). Measured with the tracing method, the area within a 5 mm diameter central circle that developed Elschnig pearls was 2.93 +/- 4.91 mm2 in the biconvex group and 1.66 +/- 2.37 mm2 in the convex-plano group. In the study, PCO was less severe in the convex-plano group than in the biconvex group following CCC. These results are contrary to those reported previously in patients with can-opener capsulotomy.

Lens epithelial cells in an in vitro capsular bag model: Lens-in-the-bag versus bag-in-the-lens technique

“…[4][5][6][7][8][9][10] Because of the great economic and functional burden of PCO, several surgical and nonsurgical strategies to prevent PCO have been proposed. These include the use of chemical substances and antibodies [11][12][13] ; hyperthermia 14 ; careful cleanup of the capsular bag 15,16 ; new IOL designs, coatings, and biomaterials [16][17][18][19][20][21][22][23] ; primary posterior continuous curvilinear capsulorhexis (PCCC) [24][25][26][27][28] ; and IOL capture or buttonholing. 29 The diversity of these recently developed therapeutical approaches relies on increased knowledge of the pathophysiology behind PCO, which is generally accepted to comprise 4 classic steps: (1) adhesion, (2) proliferation, (3) migration of the remaining LECs to the capsule, and (4) differentiation to myofibrotic cells.…”

Bendazac Lysine Inhibition of Human Lens Epithelial Cell Adhesion to Polymethylmethacrylate Intraocular Lenses

“…Several factors seem to play a role in the formation of PCO, i.e. the constituent materials and design of IOLs or postoperative inflammation related to the incision size, although the proper influence of each of these factors has to be definitely clarified [5][6][7].…”

A Preliminary Study on the Prevention of Posterior Capsule Opacification by Photodynamic Therapy with Bacteriochlorin <i>A</i> in Rabbits

“…The standard treatment for PCO is neodymium: YAG laser capsulotomy, which has been associated with considerable ophthalmic risks and is rather expensive [1]. Several techniques have been advocated for PCO prevention, including improved surgical techniques and improved intraocular lens (IOL) design and material [4][5][6], application of pharmacological and immunological agents [7,8], coating of IOLs with substances inhibiting LEC proliferation [9] and posterior continuous circular capsulorhexis [10][11][12]. However, despite these efforts, PCO still occurs in a considerable percentage of patients.…”