Mechanical anterior lens capsule polishing under viscoelastic during phacoemulsification cataract surgery

Nguyen, Chu Luan; Francis, Ian C.

doi:10.1111/ceo.12924

Cited by 8 publications

(5 citation statements)

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“…Anterior and posterior capsular opacification are still major complications of cataract surgery that occur due to the proliferation, migration, and differentiation of residual lens epithelial cells (LECs) [ 1 , 2 ]. Contact with the intraocular lens (IOL) optic causes the LECs of the anterior lens capsule to undergo fibrosis, resulting in anterior capsule opacification (ACO) [ 1 , 3 ]. This may in turn lead to contraction or retraction of the anterior capsule, and ultimately to a reduction in the free optic zone.…”

Section: Introductionmentioning

confidence: 99%

Effect of number and position of intraocular lens haptics on anterior capsule contraction: a randomized, prospective trial

et al. 2018

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BackgroundThe present study aimed to evaluate the degree of anterior capsule contraction (capsulorhexis contraction) with three different single-piece, hydrophilic acrylic intraocular lenses (IOLs).MethodsPatients were prospectively randomized to be implanted with one of three types of IOLs during cataract surgery: the Ophtec Precizon (IOL A), the Lucid Korea Microflex (IOL B), and the Carl Zeiss Asphina (IOL C). One week, 2 weeks, and 6 months after surgery, the area of the anterior capsule opening was measured using digital retro-illumination images after dilation of the pupil. The data were then evaluated using POCOman software.ResultsThe study included 236 eyes of 202 patients. The area of the anterior capsule opening reduced by 3.53 ± 3.31 mm (17.06% ± 15.99%) between 1 week and 2 months post-operatively in the IOL A group, by 0.62 ± 1.32 mm (2.87% ± 6.03%) in the IOL B group, and by 1.09 ± 1.53 mm (4.72% ± 6.10%) in the IOL C group. The IOL B group showed minimal anterior capsule contraction 2 months after surgery (p < 0.001).ConclusionsIOLs with a four-plate haptic design (IOL B) showed more anterior capsular stability than those with a two-loop plate haptic (IOL A) or two-plate haptic (IOL C) design. The number and position of haptics in a capsular bag may affect anterior capsule contraction. We assume that supporting the zonules evenly may play a role in anterior capsular stability.Trial registrationCurrent Controlled Trials ISRCTN76566080, Retrospectively registered (Date of registration: 14 Feb 2018).

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Section: Introductionmentioning

confidence: 99%

Effect of number and position of intraocular lens haptics on anterior capsule contraction: a randomized, prospective trial

et al. 2018

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“…A novel technique was designed to polish anterior capsule. [34] The polisher was used to remove remnant LECs at any point within capsular bag. The results of our meta-analysis suggested that anterior capsule polish is a kind of method to prevent the occurrence of PCO.…”

Section: Discussionmentioning

confidence: 99%

Effect of anterior capsule polish on visual function: A meta-analysis

Han

Yuan

et al. 2019

PLoS ONE

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PurposeTo investigate the relationship between anterior capsule polish and visual function.MethodsData were obtained from Pubmed, Embase, Web of Science, WanFang, VIP and CNKI up to the end of May 2018, without any date or language restrictions for trials. The modified Jadad scale and the newcastle-ottawa scale were used to assess the quality of included studies. Uncorrected visual acuity (UCVA) and posterior capsule opacification (PCO) were used as outcome variables. Data on anterior capsule polish were pooled using weighted, random-effect meta-analysis.ResultsOne randomized controlled trial and 4 observational cohort studies involving 2533 patients were included in the analyses. There was a statistically significant difference of UCVA (OR 1.92, 95% CI 1.41–2.61) between the polish group and the control group, indicating that anterior capsule polish improved UCVA. Further studies with continuous data also suggested that anterior capsule polish was associated with good UCVA (MD 0.11, 95% CI 0.06–0.16). Posterior capsule opacification rate for 1-year or longer follow-up were extracted for 2561 eyes in 3 studies. Posterior capsule opacification rate was lower in the anterior capsule polish group according to summary odds ratio on PCO rate (OR 0.42 95% CI 0.24–0.73).ConclusionsAnterior capsule polish prevents complication of modern cataract surgery and benefits on visual function in short term follow-up period.

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“…They are elongated, spindle-shaped, and contain the protein alpha-smooth muscle actin (αSMA), which is thought to give them contractile characteristics (36). Myofibroblasts deactivate synthesizing of collagen type IV and begin to produce abnormal amounts of extracellular matrix proteins: collagen type I, collagen type III, fibronectin, chondroitin sulfate, keratan sulphate (37). As a result of this process, a fibrous plaque forms under the anterior lens capsule.…”

Section: Figure 2 Posterior Capsule Opacificationmentioning

confidence: 99%

The Influence of Inflammation in Posterior Capsule Opacification Development

Todorović

Vulović

Petrović

et al. 2022

Serbian Journal of Experimental and Clinical Research

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Cataract represents the reduction of the transparency of the crystalline lens. Cataract surgery is the most commonly performed surgical procedure worldwide. One of the most common postoperative complication of successfully performed cataract surgery is a development of posterior capsule opacification (PCO). In the postoperative period, lens epithelial cells (LECs) undergo proliferation, migration and differentiation, which is clinically manifested by the development of PCO. Inflammation has a central role in these processes. Cytokines, such as transforming growth factor β, fibroblast growth factor, interleukin 1, interleukin 6, matrix metalloproteinases have a huge effect on the activity of LECs. Understanding these processes can find a great usage in clinical practice. By prescribing anti-inflammatory therapy in the early postoperative period, the incidence of PCO can be significantly reduced.

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Mechanical anterior lens capsule polishing under viscoelastic during phacoemulsification cataract surgery

Cited by 8 publications

References 5 publications

Effect of number and position of intraocular lens haptics on anterior capsule contraction: a randomized, prospective trial

Effect of number and position of intraocular lens haptics on anterior capsule contraction: a randomized, prospective trial

Effect of anterior capsule polish on visual function: A meta-analysis

The Influence of Inflammation in Posterior Capsule Opacification Development

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