Fibrosis adjacent to the anterior lens capsule after extracapsular cataract extraction

Fibrosis, contraction and opacification of the posterior lens capsule after extracapsular cataract extraction, is a frequent complication following cataract surgery. In these cases, cellular proliferation occurs along an intact posterior capsule. We report a case of fibrosis adjacent to the anterior lens capsule, where cellular proliferations and collagen production completely sealed the anterior capsulotomy three months after a routine extracapsular cataract extraction with implantation of a posterior chamber lens. The fibrosis led to contraction of the remainder of the anterior capsule, significantly reducing vision. Examination of the excised material by light and electron microscopy, and immunohistochemistry, revealed cells with features compatible with fibrocytes that did not stain positive for cytokeratin. The cells were situated in a dense collagen matrix. An anterior capsulotomy that is too small prevents sufficient removal of lens epithelium, and may be a risk factor for this complication.