Cytological factors relating to posterior capsule opacification following cataract surgery

Simulated extracapsular cataract extractions on cadaver eyes were performed which demonstrated that the cells of the anterior capsule remain largely intact and that only a small amount of cortical lens matter remains postoperatively. Human lens epithelial cells from normal and cataractous lenses were grown in culture. There was no appreciable difference in growth rate between cells from normal and those from cataractous lenses or between equatorial and central capsule cells. The cells grew from the cut edges of the capsule, suggesting that release from contact inhibition is an important factor in stimulating proliferation. The daughter cells became increasingly abnormal and metaplastic in successive generations, but there was no evidence of differentiation into fibroblasts within the 35-day culture period, suggesting that a retinal growth factor may be involved with the fibrosis occurring in opacification of the posterior capsule. A small anterior capsulotomy will release fewer cells from contact inhibition and hence reduce cell proliferation after extracapsular cataract extraction.