Phacoemulsification versus extracapsular cataract extraction: a comparative study of cell survival and growth on the human capsular bag in vitro
a West Norwich Hospital, Norwich, b School of Biological Sciences, University
of East Anglia, Norwich NR4 7TJ
Correspondence to: George Duncan.
Accepted for publication 23 July
1997
AIMS/BACKGROUND
Phacoemulsification is
rapidly replacing conventional extracapsular cataract extraction (ECCE)
as the method of choice for cataract surgery in the Western world.
However, posterior capsule opacification (PCO) still remains the major
postoperative complication, affecting 20-50% of patients, and results
from persistent cell growth of epithelial cells remaining after
surgery. This study aimed to compare cell survival and growth on
capsular bags following ECCE and phacoemulsification surgery using
an established human capsular bag culture system.
METHODSSham ECCE and phacoemulsification cataract
operations were performed on pairs of human donor eyes. Capsular bags
were dissected free, pinned flat on a petri dish, and incubated with
Eagle's minimum essential medium (EMEM) alone or EMEM supplemented
with 10% fetal calf serum (FCS). Ongoing observations were made using phase contrast microscopy.
RESULTSCell growth was observed across the
posterior capsule of all preparations studied. It was found that there
was no significant difference in the rate of cell growth on the
posterior capsule with the two extraction methods, such that 50%
confluency was achieved in 7.0 (SD 1.8) (n=7) days for ECCE and 7.43 (2.1) (n=7) days for phacoemulsification surgery. The physical changes
to the capsule as a result of cell growth, such as wrinkling and capsular tensioning, were also seen in both groups.
CONCLUSIONSCell survival and growth is dependent
on the donor, rather than the surgical technique performed. There is no
significant difference between phacoemulsification and ECCE surgery
on the rate and nature of cell growth on the posterior capsule in vitro.
* Present address: Department of Ophthalmology, Addenbrooke's Hospital, Cambridge
© 1997 by British Journal of Ophthalmology
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