Effect of lens epithelial cell aspiration on postoperative capsulorhexis contraction with the use of the AcrySof intraocular lens

Abstract

Aspiration of LECs from the anterior capsule was a safe procedure that reduced capsulorhexis aperture contraction 3 months after cataract surgery.

Role of anterior capsule polishing in residual lens epithelial cell proliferation

“…To prevent postoperative posterior capsule opacification (PCO) caused by residual lens epithelial cell (LEC) proliferation, many surgical techniques to facilitate LEC removal during cataract surgery have been developed. [1][2][3][4][5][6][7] Several studies 3,5,8,9 report that LEC removal was associated with a reduction or delay in posterior capsule fibrosis and capsular bag contraction. Other studies 10-14 challenge those findings and conclude that changes in surgical technique, such as capsule polishing, fail to prevent PCO, although a capsulorhexis size that lies on the optic diameter appears to be beneficial.…”

“…In recent years, however, with the development and rising popularity of new-generation refraction-correcting intraocular lenses (IOLs) (eg, multifocal, toric, accommodating), the clinical significance of LEC removal may become more important when a maximum optical zone is required (eg, multifocal IOLs). 5 Cataract surgeons have renewed concern about capsule opacity and capsule contraction due to remnant cell proliferation, which can undermine the effectiveness of IOLs by creating glare, halos, and difficulties with night vison. 16 Refractive cataract surgery requires an extremely high level of surgical accuracy.…”

“…It has not been established whether removal of LECs by anterior capsule polishing during surgery is beneficial or harmful. 5,8,10 The purpose of the present study was to determine whether anterior capsule polishing to remove LECs after lens substance extraction reduces LEC proliferation. Because the effectiveness of anterior capsule polishing during cataract surgery is controversial, we performed phacoemulsification on pairs of human cadaver eyes and polished the anterior capsule in 1 eye of each pair.…”

Effect of Anterior Capsule Polishing on the Need for Laser Capsulotomy

“…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].…”

Low-intensity ultraviolet A irradiation of the lens capsule to remove lens epithelial cells during cataract surgery

“…Capsule polishing, simple aspiration, ultrasound removal, ring curettes, cryocoagulation, osmolysis, and the neodymium:YAG laser have been evaluated for their ability to remove LECs. [17][18][19][20] Pharmacological methods, such as immunoconjugates, have been used in small clinical studies without obvious side effects, 21 and in vitro studies have examined antimigration drugs to minimize the effect of residual LECs. 22 Lens epithelial cell removal has been shown to be associated with a reduction or delay in fibrosis and shrinkage of the anterior capsule.…”