Anterior capsular opacification after endocapsular cataract surgery

The central parts of the opacified anterior capsules of nine eyes of nine patients after endocapsular phacoemulsification followed by posterior chamber intraocular lens implantation were removed after an average postoperative period of 25 months and examined by light and electron microscopy. The opacified materials were judged to be collagen. Transmission electron microscopy revealed fibers 50 to 60 nm in diameter, with approximately 65-nanometer periodic bands in five of the nine eyes. Most remaining cells showed multilayered proliferation and were rich in cytoplasmic microtubules and surface dendrites. These results indicate that postoperative anterior capsular opacification is composed of fibroblast-like cells, presumably transformed from lens epithelial cells and collagen.