Lens epithelial cells in an in vitro capsular bag model: Lens-in-the-bag versus bag-in-the-lens technique

Abstract

To evaluate the difference in lens epithelial cell (LEC) growth between lens-in-the-bag (LIB) implantation and bag-in-the-lens (BIL) implantation in an in vitro capsular bag model. Antwerp University Hospital, Department of Ophthalmology and University of Antwerp, Laboratory of Cell Biology and Histology, Department of Veterinary Sciences, Antwerp, Belgium. Thirty capsular bags of human donor eyes were placed in culture for 4 weeks. They were divided into 3 groups: capsular bags without intraocular lens (IOL) implantation and capsular bags with LIB or BIL implantation. Each group was divided into 3 subgroups depending on the composition of the culture medium: calf serum only; calf serum enriched with basic fibroblast growth factor (b-FGF); calf serum enriched with transforming growth factor beta (TGF-beta(2)). All capsules were evaluated by confocal microscopy. A fourth group of noncultured capsules was kept as a control. Lens-in-the-bag implantation led to extensive proliferation and differentiation of LECs; BIL implantation showed little LEC proliferation and no differentiation. Bag-in-the-lens implantation reduced LEC proliferation and prohibited LEC differentiation in the remaining lens bag of human donor eyes, proving experimentally what has been observed clinically. This finding suggests that using this peripheral part of the capsular bag can promote postoperative accommodation.