Capsule opacification after refilling the capsule with an inflatable endocapsular balloon

Abstract

Purpose: To describe the features of capsule opacification in rabbits and cynomolgus monkeys after the capsules were refilled with an inflatable endocapsular balloon.Setting: Nishi Eye Hospital, Jinshikai Medical Foundation, Osaka, Japan.Method: Capsule opacification was evaluated by slitlamp examination, Miyake view, and histopathological examination in 15 eyes of 15 rabbits and 16 eyes of 13 primates from 4 to 32 months after the lens capsule had been refilled.Results: The incidence of capsule opacification was 94%. In the eyes that did not have lens epithelial cell (LEC) removal, a monolayer of LECs was seen on the posterior capsule when the lens capsule was tautly refilled, whereas a thick layer was seen when the lens capsule was moderately or poorly refilled. In the eyes that had LEC removal, the opacification was generally less marked regardless of the amount of refilling. In two rabbit capsules that were refilled moderately or tautly and had LEC removal, the capsule remained clear. Neodymium:YAG capsulotomy in two eyes did not cause herniation of the injected silicone.Conclusions: Filling the capsule tautly and removing the LECs effectively reduced capsule opacification but could not completely inhibit LEC migration. This suggests the need for more efficient and thorough LEC removal or even a pharmaceutical approach to prevent capsule opacification after lens refilling.