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Study: Extensive capsule polishing may increase PCO rate

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MUNICH, Germany — Extensively polishing the anterior capsule following cataract removal may affect the rate of posterior capsule opacification, a small study suggests.

Matthias Wirtitsch, MD, and colleagues evaluated the effects of extensive polishing of the capsule in 96 eyes of 46 cataract patients. He presented the results here at the European Society of Cataract and Refractive Surgeons meeting.

Patients were randomly assigned to be implanted with the Advanced Medical Optics SI-40 IOL or the Bausch & Lomb Silens 6 IOL. Both are round-edged silicone lenses.

Dr. Wirtitsch said all patients underwent cataract surgery using the same technique, with the lens implanted in the bag in all cases. The capsule in one eye of each patient was extensively polished using a cannula, while the fellow eye was not polished to serve as a control.

PCO was evaluated using standard coaxial retroillumination photography at 1 year and 3 years follow-up.

By 3 years, eight patients required Nd:YAG capsulotomies in both eyes; six patients in the Silens group and two patients in the SI-40 group.

Over the course of follow-up, four patients in the Silens group and two patients in the SI40 group required Nd:YAG capsulotomies in their unpolished eyes, while eight Silens patients and four SI40 patients required capsulotomies in their polished eyes.

Dr. Wirtitsch said the differences in PCO rates were not statistically significant, but it appeared in the study that extensive polishing of the capsule increased the risk of developing PCO. He said this may be because extensive polishing decreased the amount of antifibrotic activity.