Revisiting the issue of posterior capsule opacification.

摘要

Posterior capsule opacification (PCO) remains a common complication of modern cataract surgery. This condition is treatable by performing a neodymium:YAG (Nd:YAG) laser capsulotomy, which restores good vision in most cases. However, there is significant expense involved with Nd:YAG laser capsulotomies and a small risk for complication associated with the procedure. Fortunately, over the past 2 decades, the rate of Nd:YAG laser capsulotomies has decreased significantly owing to many factors, not the least of which is surgical technique. The transition from extracapsularcataract extraction to phacoemulsification and the advent of the continuous curvilinear capsulorhexis (CCC) have allowed more thorough removal of lens material from the capsular bag. Meticulous surgical techniques, including hydrodissection and thorough cortical cleanup, have decreased the load of cortex and lens epithelial cells (LECs) within the capsular bag that can contribute to PCO. Other factors such as placement of an intraocular lens (IOL) in the capsular bag with complete overlap of the anterior capsule on the IOL optic help to ensure better contact between the posterior lens capsule and the IOL. Finally, a sharp edge on the posterior surface of the IOL can help to maintain a barrier effect to limit the proliferation of LECs across the posterior capsule.