Abstract

Background: We investigated long-term safety and efficacy of sealed capsule irrigation (SCI) during cataract surgery to prevent posterior capsule opacification (PCO).

Methods: One eye of 17 patients (mean age: 70.1±9.7 years) who presented with bilateral cataract was randomly chosen for SCI treatment. After phacoemulsification, the capsular bag was vacuum sealed with the PerfectCapsule device (Milvella) followed by SCI using distilled water for 2 minutes. No vacuum loss occurred during irrigation. The fellow eye served as a control. One hydrophilic acrylic intraocular lens model was implanted in all eyes. Five patients had to be excluded due to deep anterior chamber, small pupil or unilateral surgery. Postoperatively, follow-up examinations took place at day 1, month 1, 3, 6, 12 and 24 after surgery. We evaluated safety parameters, anterior capsule (AC) overlapping and PCO.

Results: Postoperatively, mean best corrected visual acuity, pachymetry, endothelial cell count, intraocular pressure, AC overlapping and PCO showed no statistically significant difference between SCI and control group (p<0.05, Wilcoxon test).

Conclusion: SCI is a safe procedure and enables the specific pharmacological targeting of lens epithelial cells inside the capsular bag. Using distilled water, however, it is not possible to reduce PCO development significantly, thus alternative substances should be evaluated.