Effects of Residual Anterior Lens Epithelial Cell Removal on Axial Position of Intraocular Lens after Cataract Surgery

Abstract

Purpose The aim of this study was to assess the effects of residual anterior lens epithelial cell (LEC) removal by anterior capsule polishing on the effective lens position (ELP) and axial position stability of the intraocular lens (IOL) after cataract surgery via postoperative measurement of the anterior chamber depth. Methods We enrolled 30 patients (60 eyes) requiring bilateral cataract surgery for age-related cataracts. Meticulous anterior capsule polishing and removal of residual LECs under the capsule were performed using a bimanual irrigation/aspiration system for one randomly selected eye in each patient. The eye without polishing served as a control. ELP was measured at five different time points after surgery, and axial shifting of IOL was determined at each visit by comparison with the position at the previous visit. Results The polishing and control groups showed significant differences with regard to the mean ELP at 1 (3.40 ± 0.29 versus 3.53 ± 0.32 mm, resp.; p=0.026) and 2 months (3.42 ± 0.32 versus 3.61 ± 0.35 mm, resp.; p=0.001) after surgery, the mean standard deviation for the five ELP values (0.087 ± 0.093 versus 0.159 ± 0.138 mm, p=0.001), and the root mean square of the change in ELP at each follow-up visit (0.124 ± 0.034 versus 0.246 ± 0.038 mm, p=0.047). The eyes in the control group exhibited a tendency for backward IOL movement with a concurrent hyperopic shift in refraction of approximately 0.2 diopter at 2 months after surgery. Conclusion Our findings suggest that residual anterior LEC polishing enhances the axial position stability of IOLs, without any complications, after cataract surgery.

Effect of Anterior Capsule Polishing on the Rate of Neodymium: YAG Laser Capsulotomy in Multifocal Intraocular Lens

“…A previous study indicated decreasing the polishing of anterior capsule enhances the rotational rmness of a toric IOL [18] . However, a study involving 30 patients (60 eyes) revealed that the eyes that did not undergo intraoperative ACP had a likelihood for backward IOL movement by about 0.2mm, at two months after surgery [19] . Another study posited that 360° ACP effectively reduces the incidence of the anterior capsule contraction and raises the rmness of IOL in cataract patients with high myopia [20] .…”

“…Therefore, intraoperative ACP might not be a routine choice for ophthalmologists to reduce the incidence of PCO. However, the role of ACP in maintaining the stability of IOL cannot be ignored, especially for MIOL, because some studies have shown that it reduces the occurrence of ACO and the anterior capsule contraction [18][19][20] .…”

Changes in the Density of Corneal Endothelial Cells in Elderly Diabetic Patients After Combined Phacovitrectomy and Ex-PRESS Glaucoma Implants

“…ECD levels below 800/mm 2 can result in corneal edema. Several risk factors are known to accelerate this loss, including intraocular surgery, trauma and glaucoma [5][6][7][8][9][10][11][12].…”

Study on the enlargement index of femtosecond laser-assisted capsulorhexis in 2–6-year-old patients with congenital cataract

“…Surgery should be performed during this period in patients with lens opacity, which leads to an unclear visual axis [ 4 ]. Continuous circular capsulorhexis (CCC) is the key and challenging step in cataract surgery, which influences the intraocular lens (IOL) position and postoperative refraction [ 5 – 7 ].…”