Posterior capsule opacification in pseudophakic eyes.

Area of Science:

• Ophthalmology
• Surgical Complications
• Cell Biology

Background:

• Posterior capsule opacification (PCO) is a common complication after extracapsular cataract extraction (ECCE).
• PCO impairs vision through opacity and visual distortion caused by lens epithelial cell (LEC) proliferation and contraction.

Purpose of the Study:

• To investigate the role of anterior lens epithelial cell proliferation in PCO.
• To evaluate the efficacy of a wide anterior capsulectomy in preventing or delaying PCO after ECCE.

Main Methods:

• The study examines the mechanisms of LEC proliferation and myofibroblastic differentiation on the posterior capsule.
• It analyzes the relationship between the anterior capsular flap and the initiation site of proliferation.
• The potential therapeutic benefit of a cleavage plane for intervention is discussed.

Main Results:

• Proliferation of anterior LECs onto the posterior capsule causes Elschnig pearls and frank opacity.
• Myofibroblastic differentiation of LECs leads to posterior capsule wrinkling and visual distortion.
• Proliferation originates at the apposition of the anterior capsular flap and posterior capsule.

Conclusions:

• A wide anterior capsulectomy is proposed to reduce the risk and delay the onset of PCO after ECCE.
• Posterior capsule polishing is generally ineffective unless pre-existing LEC migration is present.
• A cleavage plane between LECs and the posterior capsule offers a therapeutic target.