Posterior Capsule Opacification following the Implantation of Various Types of IOLs – Part II. Different Intraoperative Findings

Overview

Purpose:
The posterior capsule opacification (PCO) is the most frequent complication of uncomplicated extracapsular cataract extraction (ECCE). It is caused by incompletely removed epithelial cells of the original lens capsule, which proliferate and migrate along the internal anterior and posterior surface of capsule. Clinically, the PCO manifests as blurred vision and decrease of visual acuity. Opacification of the initially transparent posterior capsule occurs in patients who underwent the ECCE at variable time after surgery. According to the currently published results, the incidence of PCO varies from 10 to 40 %, 3 to 5 years after the cataract surgery (3, 4). In patients with certain types of IOLs (sharp-edged IOLs), the PCO rate has been reported as low as 5 % (2).

The anterior eye segment analyzing system is a device designed to measure the degree of PCO objectively and thus to compare the various types of IOLs, various surgical techniques and their effect on the PCO development, independently on the patient’s visual acuity. The aim of the study proposed is to assess PCO development in patients operated on at the Department of Ophthalmology of Faculty Hospital Bratislava, Slovakia, EU, by means of the EAS 1000 machine (NIDEK).

Materials and methods:
The aim of this prospective study was to evaluate the PCO development following the implantation of various IOLs types based on the measurement of the eyes of patients operated on at our department. PCO assessment was performed by EAS 1000 on day 1, day 7, and 3, 6, 12, 24, and 36 months after the cataract surgery.

Capsules of patients with various intraoperative findings were compared in the study. The first (and largest) group consisted of patients with no postoperative fibrosis and no perioperative complications (I. part). The second and third groups included patients with the intraoperative findings of posterior capsule fibrosis and patients with previous eye surgery, respectively.

Results:
No significant drop of posterior capsule transparency was detected following the implantation of various types of intraocular lenses. In the group of eyes compromised by previous surgery, the comparison was possible to be made on the first postoperative day only, yet with an insignificant result.

Conclusion:
Anterior eye segment analyzer EAS 1000 (NIDEK) allows objective evaluation of posterior lens capsule transparency using the digital retro-illumination photography. It appears that not all posterior capsule findings in eyes with intraocular lenses are suitable for such objective analysis.

Key words:
posterior capsule opacification, intraocular lens, eye analyzing system EAS 1000, polymethylmetacrylate, hydrophilic acrylate, complications