Abstract

PurposeTo establish an optical section-assisted in vivo rabbit model for capsular bend and posterior capsule opacification (PCO) investigation.MethodsA total of 10 rabbits underwent phacoemulsification surgery and intraocular lens (IOL) implantation. On the basis of the relationship between the anterior capsule and IOL, the rabbits were divided into complete overlap and incomplete overlap groups, in which six and four rabbits were included, respectively. The capsular bend optical sections were assessed using ultra-long scan depth optical coherence tomography (UL-OCT), and posterior capsule opacification was evaluated with slit lamp on postoperative day 3, 7, 14, and 28. In addition, histopathological section was used to verify the accuracy of capsular bend type captured by OCT in three rabbits.ResultsBased on the special animal model, six capsular bend types were observed, namely, anterior (A), middle (M), posterior (P), detachment (D), funnel (Fun) and furcate adhesion (Fur). On day 3, capsular bend began to form. On 14 days, the capsular bends were comprised of A, M and D types, which were almost maintained until day 28. Histopathological section findings were consistent with optical sectioning results. In the incomplete and complete groups, the earliest PCO within the optical zone were on day 7 and 28, respectively. The incomplete group exhibited higher incidence and faster PCO on day 7 (p = 0.038) and 14 (p = 0.002).ConclusionsThis animal model not only mimics capsular bend evolution and PCO processes but also produces OCT optical section images equivalent to and more repeatable than histopathology, thereby providing a promising method for the further investigations of PCO.

Highlights

  • Posterior capsule opacification (PCO) results from the migration and proliferation of residual lens epithelial cells (LECs) is the main cause of secondary visual loss following cataract surgery

  • The capsular bend optical sections were assessed using ultra-long scan depth optical coherence tomography (UL-OCT), and posterior capsule opacification was evaluated with slit lamp on postoperative day 3, 7, 14, and 28

  • Based on the relationship between the anterior capsule and intraocular lens (IOL), the rabbits were divided into complete overlap group (CO group, i.e., the anterior capsular edge completely overlapped with the IOL optic edge) and incomplete overlap group (ICO group, i.e., the anterior capsule did not cover the IOL optic edge or showed significantly eccentric overlap), which comprised six and four rabbits, respectively

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Summary

Introduction

Posterior capsule opacification (PCO) results from the migration and proliferation of residual lens epithelial cells (LECs) is the main cause of secondary visual loss following cataract surgery. Previous studies [2,3,4,5,6] demonstrated that the capsular bend induced by IOL with a sharp optic edge can prevent PCO. The underlying mechanism of how sharp edge-designed IOL prevents PCO remains controversial. Nishi et al [3] reported that capsular bends which acted like an mechanical barrier, inhibit LECs proliferation and migration through contact inhibition effect. Nagamoto et al [7] emphasized that the compression between IOL and capsular bag plays an important role in PCO prevention

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