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C.H. W. Yuen, R.L. Williams, M. Batterbury, I. Grierson; Modifying Posterior Capsular Opacification Using a Biological Sandwich . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2859.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Posterior capsular opacification (PCO) is a common cause for visual deterioration after successful cataract surgery. Our previous work has shown that surface properties of lens implant materials significantly affect cellular adhesion and differentiation. PCO is a form of wound healing. This study aims to modify PCO by preserving normal epithelial cell phenotype within the capsular bag in vitro. Methods: PMMA, silicone and a hydrophobic acrylic polymer were the materials used. These materials were treated with a quantifiable, low–energy gas plasma to create different surface properties. Bovine lens epithelial cells (BLECs) were seeded onto these materials until confluent monolayers had developed. Lens capsules were carefully dissected from fresh bovine eyes in sham cataract operations. The materials coated with the monolayers of BLECs were implanted into these capsules "face down". Each material, layer of cells and the posterior capsule then form a "biological sandwich". These sandwiches were sustained in culture using Dulbecco’s Modified Essential Medium with 20% foetal calf serum. Serial photographs were taken for comparison at days 7, 14 and 30. The specimens were then fixed and stained with haematoxylin. Results: The gas plasma treatment increased the hydrophilicity of the materials significantly. This was demonstrated by dynamic contact angle measurements. BLECs adhered better to hydrophilic surfaces throughout, with better retention of their normal, cuboidal, epithelial–cell morphology. Within the biological sandwiches cultured, the ones with normal, epithelial–like cells fared best. There were less posterior capsular wrinkling due to contraction and opacification when compared with capsules inhabited by cells with a fibroblastic morphology. Conclusions: Much emphasis had been on the elimination of residual lens cells in the capsule as means of preventing PCO. We have shown that surface properties are important in controlling cellular settlement and differentiation which, in turn, determines cellular behaviour. Our capsular work demonstrates that PCO can be inhibited by promoting normal cellular behaviour within the residual lens cells present. By recreating a normal biological sandwich for these lens cells in vivo, one may have a viable solution to the problems posed by PCO. Further in vitro models are underway.
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