Pathogenesis of posterior capsular opacification Part II: Histopathological and in vitro culture findings

Abstract

The most interesting sources of information about the pathogenesis of posterior capsular opacification seem to be histopathological studies and in vitro tissue cultures. Since our surgical technique is extracapsular cataract extraction, the explants we used for tissue culture consisted of the anterior capsule epithelial sheet without the equatorial germinative zone. We successfully overcame several problems by using the autologous plasma clot culture method. This medium, considered the optimal one for this type of culture, allowed us to study the heterogeneous behavior of the epithelial cells in culture. Using the plasma clot culture method, we were able to demonstrate in vitro fibroblastic transformation of the epithelial cells. Histopathological findings of particular cases of posterior capsule opacification and immunohistochemistry of the human lens are also reported.

Posterior fibrous pseudometaplasia of lens epithelial cells in phacic eyes filled with silicone oil

“…It is accepted that posterior migration of lens epithelium is one histological feature of cataract formation. On in vitro culture of lens epithelial cells, Frezotti et al [12] found two principal forms of evolution of these cells, i.e. fibrosis (pseudometaplasia) and multiple pearl-like formation (Elschnig cells).…”

Ex vivo canine lens capsular sac explants

“…SMA, a specific marker for myofibroblastic cells, has been previously shown to accumulate in cultured LEC exposed to certain growth factors [12,17], anterior subcapsular cataracts [32], and PCO [9,18]. Importantly, LEC producing SMA are thought to be responsible for the localized capsular wrinkling associated with PCO and which is often associated with light scatter.…”

Polylactide-glycoli acid and rapamycin coating intraocular lens prevent posterior capsular opacification in rabbit eyes

“…Most oculists believe that remaining LECs are able to proliferate and migrate to form a monolayer, or multilayers of cells over the anterior surface of the posterior capsule. It is believed that the cells in this membrane undergo phenotypic change to fibroblast-like cells, whose contraction causes extensive wrinkling of the posterior capsule [11][12][13] and which, in addition, secrete extracellular matrix [14,15].…”