Long-term Study of Posterior Capsular Opacification Prevention With Endocapsular Equator Rings in Humans

Objective: To confirm the effect of a square-edged, closed endocapsular equator ring (E-ring) for preventing posterior capsular opacification (PCO) after cataract extraction. Methods: Fifty-one eyes underwent cataract surgery associated with E-ring implantation between October 2002 and March 2008. Group 1 included 14 patients (14 eyes) who received an E-ring and intraocular lens (IOL) in 1 eye before March 2006. Their fellow eyes received only an IOL as controls. Group2 included 23 patients (37 eyes) who received an E-ring and IOL in 1 or both eyes after March 2006 and another 37 age-matched control eyes with only IOL implants. After cataract removal, the E-ring (1.0 mm wide and thick and 9.0 or 9.5 mm long) was implanted in the capsule and an IOL was fixed in the ring. In the control eyes, only an IOL was implanted. The follow-up periods were 2 to 7 years. The PCO value was determined using the Hayashi method. Results: Two years postoperatively in group 1, the PCO value in the central area of the eyes with an E-ring was significantly lower than in the controls (4.4 vs 11.4, respectively; P=.005). No eyes with an E-ring required Nd:YAG laser posterior capsulotomy postoperatively compared with 23 of 51 control eyes (45%). The posterior capsule in the eyes with an E-ring remained transparent without touching the IOL optic. The 9.5-mm ring fit all eyes. Conclusion: The 9.5-mm E-ring, which fit all eyes, prevented PCO in human eyes 2 to 7 years postoperatively.