Membranous outgrowth suggesting lens epithelial cell proliferation in pseudophakic eyes

We sought to determine the incidence and structure of membranous outgrowth, which extends from the anterior capsular opening onto the intraocular lens surface in pseudophakic eyes.

Thirty-four eyes of 31 patients with age-related cataract were prospectively studied. No patient had any abnormality other than cataract. Each patient underwent continuous circular capsulorhexis, phacoemulsification, and implantation within the capsule of a three-piece posterior chamber lens. A slit lamp and specular microscope were used to observe and photograph the intraocular lens surface and anterior capsular opening every day for the first postoperative week, and at days 14, 21, and 28. We counted the number of eyes with the membranous outgrowth and graded the outgrowth according to its shape and length at each postoperative period.

In total, 27 of 34 (79%) eyes had the membranous outgrowth from the anterior capsular opening onto the intraocular lens surface. The membrane was first observed on day 3. Three of 34 eyes had the dendritic or fan-shaped structure, which extended less than 0.5 mm from the capsular edge. The membranes were most frequently found on day 7. Twenty-five of 34 eyes had the outgrowth in various grades. After four weeks, no membranes were observed.

The time course and structure of the membranous outgrowth we observed were comparable to those of the outgrowth of lens epithelial cells under tissue culture conditions. The membranous outgrowth may be the result of a transient but active proliferation of human lens epithelial cells onto the intraocular lens surface.