[The influence of the lens capsule mechanical polishing to the secondary cataract development]

The aim of the prospective study was to evaluate the long-term effect of the lens epithelial cells (LEC) removal by means of the lens capsule mechanical polishing on the development of the anterior capsule opacification (ACO) and posterior capsule opacification (PCO).

The study group consisted of 28 patients, average age 57 years (27-87 years), who underwent the cataract surgery of both eyes. Out of the 28 patients, the follow up examination after two or more years attended 23 of them. For the irrigation and aspiration after the phacoemulsification, the bimanual (newly also called biaxial) irrigationlaspiration from two service, 1 mm wide, opposite (at the 3 and 9 o'clock positions) incisions was used. In each patient, the lens capsule of one eye was mechanically polished in the maximal mydriasis (at least 5 minutes) with a specially constructed 5 openings aspiration cannula designated especially for the LEC aspiration in the equator area. The anterior capsule was cleaned by means of the standard one opening aspiration cannula. In the other eye of the same patient, the LEC of the anterior capsule were left intact. There was implanted the same type of the intraocular lens in both eyes. The examination after more than two years after the surgery consisted of biomicroscopic examination, taking the photograph of the intraocular lens and the lens capsule in retro illumination, and examining of the anterior segment by means of the Scheimpflug camera (Pentacam) with measuring the density of the anterior and posterior lens capsule. The Wilcoxon pair test was used for the statistical evaluation.

Using the Pentacam system objective densitometry, there was found statistically significant lower density of the anterior lens capsule in eyes with peroperative mechanical polishing of the lens capsule including the equator and the anterior capsule. Among the values of the density of the posterior capsule, there were found no statistically significant differences, although in 43% of patients, in the eye with the polished capsule, there were visually less dense opacities of the posterior capsule.

According to the obtained results it may be stated that the mechanical polishing of the lens capsule, including the equator and the anterior capsule, causes significantly lower degree of opacities of the anterior capsule (ACO), but has not statistically significant influence to the development of the PCO.