Centripetal lens epithelial cell migration: a prospective study of the Alcon SA60AT intraocular lens

To evaluate prospectively the incidence and severity of centripetal lens epithelial cell migration (CLECM) onto the anterior surface of the Alcon SA60AT intraocular lens (IOL).

One hundred and four consecutive cases of SA60AT IOL implantations were prospectively evaluated. At the 1-month postoperative visit, best corrected visual acuity (BCVA) was obtained. Following maximal pupillary dilatation, the extent of CLECM was assessed using a simplified grading scale (0-4). The centrality of the lens within the capsular bag was recorded. Patients with the highest grade of CLECM were recalled for reassessment at a minimum of 3 months.

Centripetal lens epithelial cell migration data were obtained on 99 patients. Of these, 94% demonstrated CLECM of varying severity at 1 month postoperatively. The severity was low grade in 54% of patients (29% grade 1, 24% grade 2), and high grade in 40% of patients (16% grade 3, 24% grade 4). BCVA results were good (91.9% 6/6 or better) and did not correlate with CLECM grade. Operative capsulorhexis size did not correlate with the severity of CLECM. The lens was well-centred in 91 of 92 patients in whom lens position was assessed. Twenty-three patients with grade 4 CLECM at 1 month were brought back for reassessment (3.5-13 months postoperatively) and 18 of these demonstrated complete regression of CLECM (to grade 0).

There is a high incidence and severity of CLECM 1 month postoperatively using the Alcon SA60AT IOL. There was no significant correlation between CLECM grade and either BCVA at 1 month, capsulorhexis size or lens centration. CLECM appears to be a frequent, benign and transient event with this lens.