Abstract
Purpose :
Meticulous construction of an adequate capsulorhexis is the cornerstone of successful cataract surgery. The rate of development of posterior capsular opacification (PCO) has been found to be reduced when capsulorhexi are made smaller, centrally and overlapping the optic. However, there have not been recent studies assessing for the capsulorhexis factors contributing to PCO in post mortem eyes with intraocular lenses (IOL) and operated using newest phacoemulsification machines. This study aims to evaluate the capsulorhexis structure in post-mortem eyes and determine factors associated with PCO.
Methods :
A total of 246 post-mortem pseudophakic human eyes were obtained from the Minnesota Eye Bank and examined at the MUHC-McGill University Ocular Pathology & Translational Research Laboratory. Microscope photographs were taken of the eyes in Miyake view and of the extracted lens-capsule complex. PCO and Soemmering’s Ring (SR) density, were quantified using Automated Detector Opacification Software (ADOS) as a factor of intensity and area. Miyake views and graphical analysis software were used to assess capsulorhexis area, area of non-overlap of the anterior capsule with the IOL, size of the shortest anterior capsular leaflet, and area of anterior capsule coverage on the IOL. Linear regression analysis was used to determine the relationship of these factors with PCO and SR formation as well as statistical significance.
Results :
Capsulorhexis area showed a weak negative correlation (R2 = 0.06) with PCO formation (P<0.0001), although with only a modest effect (slope = -0.019). Anterior capsular coverage area was positively correlated with both PCO (R2 = 0.10, slope = 0.027, P< 0.0001) and SR (R2 = 0.02, slope = 0.213, P= 0.011), but again with only week association. Area of non-overlap of the anterior capsule with the IOL and size of the shortest anterior capsular leaflet were not significantly associated with PCO or SR formation.
Conclusions :
The pathogenesis of PCO development after cataract surgery is multifactorial. This study shows that with modern operating technology, rhexis factors have at best a modest influence on PCO formation. Factors such as time from surgery to death and intra-operative capsular polishing technique likely play a more significant role.
This is a 2021 ARVO Annual Meeting abstract.