POSTERIOR CAPSULE OPACIFICATION

Posterior capsule opacification is a frequent complication of extracapsular cataract extraction (ECCE). Recent efforts aimed at elucidating the mechanism of capsular opacification include demonstration of in vitro fibroblastic transformation of lens epithelial cells and the observation that advanced cataracts have significantly increased epithelial cells when compared to other cataract types which may explain differences in regenerative capability of residual lens epithelium in certain cataracts. Studies on the possible benefits of specific designs and the frequency of posterior capsule opacification suggest that factors such as closer apposition of the lens optic and the posterior capsule via in-the-bag placement of posterior chamber intraocular lenses, use of bag fixated silicone lenses, and use of plano convex/biconvex lens design versus laser ridge or laser "peg" optics have been associated with lower rates of capsular opacification. Despite its potential benefits, damage to the biconvex designed intraocular lens during Nd:YAG (neodymium-yttrium-aluminum-garnet) laser capsulotomy has been a concern. However, recent data suggests that although laser shots produced tiny visible marks on this IOL, no significant visual symptoms or measurable glare disability manifested that could be attributable to the lens damage.