Temperature Threshold for Cell Death of Lens Epithelial Cells in a Human Capsular Bag Model

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.…”

“…From the literature, it is apparent that although many nonsurgical approaches have also been evaluated, only surgical methods have proved efficient in preventing PCO. [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Our department developed a new type of IOL aimed at capturing the LECs in a closed area and blocking their migration toward the visual axis. The implantation concept is called the bag-in-the-lens (BIL) technique, in which both the anterior and posterior capsules are inserted in a groove at the margin of the IOL optic (Figure 1, top).…”

Effect of bag-in-the-lens implantation on posterior capsule opacification in human donor eyes and rabbit eyes

“…As a result of improvements in cataract surgery, 11,12 IOL design, [13][14][15][16][17][18] and new biomaterials, 18,19 the rate of PCO has decreased considerably, 20 but it is far from zero. Approaches to prevent LEC proliferation by killing LECs with pharmaceutical agents [21][22][23] or physical techniques such as hyperthermia 24 and photodynamic therapy 25 have not been clinically successful, primarily because of their toxicity to adjacent ocular tissues, especially the corneal endothelium. Removal of the central part of the posterior capsule by a posterior continuous curvilinear capsulorhexis (PCCC) prevents PCO in many cases, 26 but not all.…”