Evaluation of laser capsule polishing for prevention of posterior capsule opacification in a human ex vivo model

Abstract

To evaluate the efficacy of a laser photolysis (LP) system in preventing posterior capsule opacification (PCO) in a human ex vivo PCO model. Ars Ophthalmica Study Center, Department of Ophthalmology, General Hospital Linz, Medical Faculty of Johannes Kepler University, Linz, Austria, and the Department of Ophthalmology, Ludwig-Maximillians-University, Munich, Germany. Prospective randomized controlled laboratory trial. Open sky extracapsular cataract extraction following implantation of a capsular tension ring (CTR) into the capsular bag was performed in 28 human donor eyes. Donor eyes received LP treatment of the capsular bag fornix and the anterior capsule for 180 or 360 degrees, whereas the contralateral eyes served as a control group. Lens epithelial cell (LEC) growth onto the posterior capsule was determined objectively during 3 months of organ culture incubation. The mean interval until a complete monolayer of LECs on the posterior capsule had formed was 8.2 days ± 1.2 (SD) for control eyes and 9.4 days ± 1.1 for eyes with 180-degree LP treatment (P = .042). Eyes with 360-degree treatment showed no sign of LEC growth or migration onto the posterior capsule during the entire observation period. Transmission light microscopy revealed many residual LECs on the anterior lens capsule of untreated areas, whereas no evidence of remaining LEC in areas treated with LP was found. This study demonstrates complete and sustained PCO prevention by a prototype LP system in a capsular tension ring-based human ex vivo model. Laser capsule polishing has the potential to serve as a successful surgical strategy for PCO prevention. The authors have no proprietary or financial interest in any of the materials or equipment mentioned in this study.