Effect of Anterior Capsule Polishing on the Capsule-IOL Complex in Patients With Normal Axial Length: A Prospective
Wenkai Huang1,2,3, Chenyuan Zhu1,2, Xuechuan Miao1,2
1National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Journal of Refractive Surgery (Thorofare, N.J. : 1995)
|March 7, 2026
Summary
Anterior capsule polishing (ACP) in cataract surgery slows capsule-intraocular lens complex maturation and stabilizes the capsulorhexis. However, it increases vertical intraocular lens tilt, suggesting selective use when precise alignment is critical.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Medical Optics
Background:
- Cataract surgery involves implanting an intraocular lens (IOL) within the eye's lens capsule.
- Postoperative capsule-intraocular lens (C-IOL) complex formation can affect visual outcomes.
- Anterior capsule polishing (ACP) is a technique used during surgery.
Purpose of the Study:
- To evaluate the effect of anterior capsule polishing (ACP) on the postoperative capsule-intraocular lens (C-IOL) complex in patients with cataract and normal axial length.
- To assess the impact of ACP on capsular bend index, adhesion index, and capsulorhexis diameter.
Main Methods:
- A prospective randomized controlled trial comparing 360° ACP versus no polishing.
- Quantitative assessment of C-IOL complex parameters using swept-source optical coherence tomography (SS-OCT) at 1 week, 1 month, and 3 months.
- Evaluation of IOL tilt, decentration, visual acuity, and refraction as secondary outcomes.
Main Results:
- At 3 months, ACP significantly reduced capsular bend index and adhesion index, and increased capsulorhexis diameter compared to controls.
- ACP demonstrated less capsulorhexis contraction but resulted in greater vertical IOL tilt and its root mean square.
- No significant differences were observed in horizontal tilt, decentration, corrected distance visual acuity, or spherical equivalent refraction between groups.
Conclusions:
- Anterior capsule polishing (ACP) slows early C-IOL structural maturation and stabilizes the capsulorhexis.
- ACP increases vertical IOL tilt, necessitating caution when precise IOL alignment is required.
- Findings support selective use of ACP in eyes prone to capsular contraction.
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