Incidence of primary peripheral posterior capsular opacification after cataract surgery and posterior capsular opacification in the patients implanted with foldable intraocular lenses

Joshi, Rajesh Subhash

doi:10.3126/nepjoph.v9i2.19259

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…A total of 1400 eyes undergoing cataract surgery with peripheral pre-existing PCO (PPPCO) were either implanted with a hydrophobic or hydrophilic IOL. PPPCO is often seen in the developing world due to the late presentation of patients and in some cases of blunt ocular trauma [61,62]. The study found PPPCO patients implanted with a hydrophilic IOL had a higher propensity towards PCO development than those implanted with a hydrophobic IOL.…”

Section: Intraocular Lens-associated Risk Factorsmentioning

confidence: 82%

“…The choice of material, design, and function of the IOL can greatly impact risk of developing PCO. A prospective study conducted by Joshi [61] exemplifies the importance of IOL selection for patients with pre-existing conditions. A total of 1400 eyes undergoing cataract surgery with peripheral pre-existing PCO (PPPCO) were either implanted with a hydrophobic or hydrophilic IOL.…”

Section: Intraocular Lens-associated Risk Factorsmentioning

confidence: 99%

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Factors Affecting Posterior Capsule Opacification in the Development of Intraocular Lens Materials

Cooksley

Lacey²,

Dymond

et al. 2021

Pharmaceutics

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Posterior capsule opacification (PCO) is the most common complication arising from the corrective surgery used to treat cataract patients. PCO arises when lens epithelial cells (LEC) residing in the capsular bag post-surgery undergo hyper-proliferation and transdifferentiation into myofibroblasts, migrating from the posterior capsule over the visual axis of the newly implanted intraocular lens (IOL). The developmental pathways underlying PCO are yet to be fully understood and the current literature is contradictory regarding the impact of the recognised risk factors of PCO. The aim of this review is firstly to collate the known biochemical pathways that lead to PCO development, providing an up-to-date chronological overview from surgery to established PCO formation. Secondly, the risk factors of PCO are evaluated, focussing on the impact of IOLs’ properties. Finally, the latest experimental model designs used in PCO research are discussed to demonstrate the ongoing development of clinical PCO models, the efficacy of newly developed IOL technology, and potential therapeutic interventions. This review will contribute to current PCO literature by presenting an updated overview of the known developmental pathways of PCO, an evaluation of the impact of the risk factors underlying its development, and the latest experimental models used to investigate PCO. Furthermore, the review should provide developmental routes for research into the investigation of potential therapeutic interventions and improvements in IOL design in the aid of preventing PCO for new and existing patients.

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Section: Intraocular Lens-associated Risk Factorsmentioning

confidence: 82%

Section: Intraocular Lens-associated Risk Factorsmentioning

confidence: 99%

Factors Affecting Posterior Capsule Opacification in the Development of Intraocular Lens Materials

Cooksley

Lacey²,

Dymond

et al. 2021

Pharmaceutics

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show abstract

“…PCO is a common long-term complication of cataract phacoemulsification. Multiple studies have investigated various strategies to prevent and treat PCO, including surgical techniques, drug research [ 12 ] and intraocular lens design [ 13 , 14 ]. Objective quantitative measurement of PCO is crucial in evaluating the effectiveness of such interventions and assessing the clinical course.…”

Section: Discussionmentioning

confidence: 99%

Objective quantification of posterior capsule opacification after cataract surgery with swept-source optical coherence tomography

Xiang

Xü

et al. 2023

BMC Ophthalmol

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Purpose To evaluate the application of swept-source optical coherence tomography (SS-OCT) and pentacam scheimpflug tomography in posterior capsule opacification (PCO) severity assessment. Methods The posterior capsule image region segmentation and adaptive threshold algorithm are used to process the SS-OCT scanned image to obtain the posterior capsule thickness (PCT). Scheimpflug tomography reconstructed and analysized by image J software can obtain the average gray value and evaluate the effectiveness with the two methods. Result One hundred sixty-two IOL eyes of 101 patients were divided into two groups, laser group (65 eyes) with the mean PCT was 8.0 ± 2.7 pixel unit and the mean gray value of the eyes was 66 ± 33 pixel unit. However, these figures in the control group (97 eyes) were 5.0 ± 0.9 and 11 ± 17. The sensitivity, specificity and area under curve(AUC) of SS-OCT PCT were 85%, 74% and 0.942,the sensitivity, specificity and AUC of Pentacam gray value were 91%, 76% and 0.947, respectively. After using the multivariable model of generalized estimation equation to corrected the dependence of subjects' eyes, it was found that SS-OCT PCT, Pentacam gray value, low vision quality of life questionnaire (LVQ questionnaire) for distance vision, and mobility and lighting dimension were significantly correlated with the PCO score (P = 0.012, P = 0.001, P = 0.005, respectively). Conclusion The region segmentation and adaptive threshold algorithm of posterior capsule image will accurately quantify the posterior capsule. Computer aided quantifications of posterior capsule are of great significance in the early surgical decision-making of PCO. The average occurrence time of most PCO was around 34 months, and the severity of PCO worsened with increasing postoperative time.

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“…1 Masood 2 reported an incidence of 31% in hypermature cataracts. In a recent study, Joshi 3 reported an incidence of 5.7% of pre-existing or primary posterior capsular opacity in patients undergoing phacoemulsification of senile cataract. It was established that it was caused by a mature cataract in 47.5%, a posterior subcapsular cataract in 36.2% and a posterior polar cataract in 16.2% of the cases.…”

Section: Introductionmentioning

confidence: 99%

Removing residual cortical material during cataract surgery: Visco polishing and the grindstone effect as a new surgical technique

Borkenstein

Malyugin

2021

European Journal of Ophthalmology

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Purpose To describe a new technique for removing residual cortical material adjacent to posterior lens capsule during cataract surgery with the help of cohesive ophthalmic viscosurgical devices. Methods In this technique, if there are still cortical remnants and lens epithelial cells left after the routine irrigation–aspiration and polishing at the final steps of cataract surgery, the capsule is filled to about one-third with a highly viscous cohesive ophthalmic viscosurgical device. Rinsing is performed from the anterior chamber with the water jet directed tangentially to the ophthalmic viscosurgical device bolus and towards the posterior capsule, which creates a turbulence creating a “grindstone effect”. The ophthalmic viscosurgical device bolus transforms into a ball and starts to rotate very quickly within the capsule, grinding away the cortical remnants. Results In the first series of 62 cases, there were no intra-operative or post-operative complications. At day 1 there was no corneal oedema and no hypertension of intraocular pressure. Visual outcomes were good with a mean best corrected distance visual acuity of −0.01 ± 0.11 logMAR. Conclusion This technique appears to be effective and fast in removing persistent cortical remnants from the surface of the posterior capsule, while minimising risks such as capsule aspiration during irrigation/aspiration. There is limited pressure and mechanical force applied on the capsule; the anterior chamber and the corneal endothelium remain safe since the ophthalmic viscosurgical device stays inside the capsular bag to its high cohesiveness and molecular weight. More data on a larger cohort of patients is planned to confirm these results and evaluate long-term effects on posterior capsule opacification.

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Incidence of primary peripheral posterior capsular opacification after cataract surgery and posterior capsular opacification in the patients implanted with foldable intraocular lenses

Abstract: PPPCO is a frequent occurrence in mature cataract and there is a higher incidence of PCO in PPPCO patients implanted with hydrophilic IOL than with hydrophobic IOL. Therefore, hydrophobic IOL should be considered for patients discovered to have PPPCO during cataract removal.

Cited by 3 publications

References 6 publications

Factors Affecting Posterior Capsule Opacification in the Development of Intraocular Lens Materials

Factors Affecting Posterior Capsule Opacification in the Development of Intraocular Lens Materials

Objective quantification of posterior capsule opacification after cataract surgery with swept-source optical coherence tomography

Removing residual cortical material during cataract surgery: Visco polishing and the grindstone effect as a new surgical technique

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