Study suggests floating lens epithelial cells do not cause PCO

The authors conducted this study to analyze the natural history of focal collections of lens epithelial cells (LECs), or islands of LECs, on the posterior capsule after cataract surgery. Determining the derivation of these islands of LECs may help with developing strategies to eliminate posterior capsule opacification (PCO).

The authors retrospectively evaluated 106 eyes (67 patients) included in previous studies who underwent phacoemulsification and IOL implantation for bilateral age-related cataracts at one hospital and were followed for at least two years. They examined postoperative digital retroillumination images of each eye taken at one, three and six months and one and two years.

The authors identified islands of LECs in all eyes, of which 39 were implanted with an AcrySof SA60AT IOL, 40 with a Rayner Centerflex C570H IOL and 27 with a Hoya YA60BB IOL. The islands tended to appear within six months, with their incidence decreasing thereafter. Floating LECs that seeded on the posterior capsule or LECs left on the posterior capsule at surgery were seen in a small number of eyes. Most islands were derived from regression of a previous LEC membrane, and a majority continued to regress. IOL material had no influence on the natural history or morphology of the islands.

The authors conclude that islands of LECs were common postoperatively. Equatorial LECs appeared to be the major cause of clinical PCO. Floating LECs in the aqueous that seeded on the posterior capsule or LECs left behind after surgery did not appear to contribute to clinical PCO.