Influence of intraocular lens implantation on anterior capsule contraction and posterior capsule opacification

PURPOSE: To evaluate whether and how intraocular lens (IOL) implantation influences the development of anterior capsule contraction and posterior capsule opacification (PCO). SETTING: Department of Ophthalmology, Dokkyo Medical University, Mibu, Tochigi, Japan. DESIGN: Experimental study. METHODS: Phacoemulsification was performed in 8-week-old white rabbits. A hydrophobic acrylate IOL (12.5 mm) (YA-60BBR) was implanted in 1 eye and no IOL was implanted in the fellow eye. Slit lamp microscopy and anterior segment analysis were performed to evaluate anterior capsule contraction after the surgery. Four weeks postoperatively, sections of the eyes were made, and the thickness of the proliferated lens epithelial cell (LEC) layer at the posterior capsule was measured to assess the PCO. In addition, LECs from white rabbits were cultured in medium containing 50% aqueous humor or in medium containing 50% saline to determine the influence of the aqueous humor on LECs and to compare the degree of LEC proliferation. RESULTS: Starting 2 weeks after surgery, anterior capsule contraction progressed more significantly in the IOL group than in the group without IOLs. Four weeks postoperatively, LEC thickness at the posterior capsule was significantly less in the group without IOLs than in the IOL group. In the culture study, LEC proliferation was more inhibited in the aqueous humor group than in the saline group. CONCLUSIONS: Progression of anterior capsule contraction and PCO is less likely in aphakic eyes than in IOL-implanted eyes. The mechanism of prevention may involve aqueous humor induced inhibition of LEC proliferation.