Adhesion of IOLs to the posterior capsule

Posterior capsule opacification (PCO) occurs in up to 50% of patients within 5 years following extracapsular cataract extraction (ECCE) surgery.1 Residual lens epithelial cells proliferate and migrate onto the posterior capsule where they may undergo phenotypic change to form contractile fibroblast-like cells which secrete extracellular matrix material. Massive proliferation results in multilayering of these cells on the posterior capsule and the formation of fibrotic membranes. Residual lens epithelial cells also form clusters of swollen Elschnig’s pearls as a result of their failed attempts to form new fibre cells. These fibrotic membranes and/or Elschnig’s pearls, if allowed to reach the visual axis, may cause significant visual loss as a result of the diffraction of light by the accumulated mass of cells and matrix.1-3 In these cases, the patients once again have their vision compromised and often require a Nd:YAG laser posterior capsulotomy. This treatment is associated with the increased risk of a number of complications such as …