Strategies to reduce cytokine levels could suppress PCO progression

Abstract

AbstractPurpose Posterior capsule opacification (PCO) develops after cataract surgery. Open bag IOLs, in contrast to current IOL devices, separate anterior and posterior capsules (PC) and are proposed to aid wash out of cytokines in the capsular bag that may promote PCO. The current study assessed the correlation between cytokine availability and cell growth on the human capsular bag.Methods To assess cell growth in different volumes (1.5 Vs 6ml) of Serum‐Free (SF) EMEM we employed a human capsular bag model. We further adapted the capsular bag system, such that radial incisions were made in the anterior capsule, which was then folded back and secured to a dish (a fully open bag model). Cell growth was observed by phase‐contrast microscopy and quantified by ImageJ software. Cytokines were detected by Bioplex suspended bead array at culture day 2. Immunocytochemistry was used to detect myofibroblasts (using the marker alpha smooth muscle actin;αSMA) and cell density.Results Increasing media volume significantly reduced the cell coverage rate on the central PC. A significant cytokine reduction was observed (9 of the 27 assessed) in 6ml cultures compared to 1.5ml counterparts; no cytokines were significantly elevated. At end‐point (28 days) capsular bags maintained in 6ml of media exhibited decreased cell density in the peripheral PC and reduced αSMA expression. Fully open capsular bags cultured in 1.5 or 6ml SF EMEM had limited cell progression onto the PC in both volumes. Fully open capsular bags exposed to 5% human serum demonstrated rapid colonisation of the PCConclusion Reduced cytokine availability is associated with impaired cell growth on the capsular bag. It is likely that open bag devices will restrict cytokine levels and improve the management of PCO.