Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2023, Vol. 37 ›› Issue (4): 181-186.doi: 10.6040/j.issn.1673-3770.0.2022.112

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Research progress on the pathogenesis of posterior capsular opacification and on anterior capsular polishing

HAN Yiping1,2, ZHANG Han1,2   

  1. 1. Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China2. Department of Ophthalmology, Shandong Provincial Hospital, Jinan 250021, Shandong, China
  • Published:2023-07-27

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Abstract: Posterior capsular opacification(PCO)is the most common postoperative complication of cataract surgery, and its occurrence and development are closely related to lens epithelial cells. Neodymium-doped yttrium aluminum garnet(Nd:YAG)laser posterior capsulotomy is a common method for the treatment of PCO. However, it has low universality and is associated with ocular complications. Therefore, the development of safe and effective strategies to prevent PCO remains a concern. This article reviews the pathogenesis of PCO and the technological progress of anterior capsular polishing in the clinical prevention of PCO.

Key words: Cataract, Anterior capsular polishing, Posterior capsular opacification, Lens epithelial cells

CLC Number: 

  • R776.1
[1] Kossack N, Schindler C, Weinhold I, et al. German claims data analysis to assess impact of different intraocular lenses on posterior capsule opacification and related healthcare costs[J]. Z Gesundh Heal, 2018, 26(1): 81-90. doi:10.1007/s10389-017-0851-y
[2] Maedel S, Evans JR, Harrer-Seely A, et al. Intraocular lens optic edge design for the prevention of posterior capsule opacification after cataract surgery[J]. Cochrane Database Syst Rev, 2021, 8(8): CD012516. doi:10.1002/14651858.CD012516.pub2
[3] 滕贺, 张红, 田芳, 等. 环孢霉素A修饰人工晶状体抑制兔眼后发性白内障的研究[J]. 中华眼科杂志, 2016,52(2): 110-116. doi:10.3760/cma.j.issn.0412-4081.2016.02.007 TENG He, ZHANG Hong, TIAN Fang, et al. The study of cyclosporin A modified intraocular lens preventing posterior capsular opacification in rabbit eyes[J]. Chinese Journal of Ophthalmology, 2016,52(2): 110-116. doi:10.3760/cma.j.issn.0412-4081.2016.02.007
[4] 孔德倩, 郑广瑛, 李莉, 等. Smac对人晶状体上皮细胞增生的抑制作用及促凋亡作用[J]. 中华实验眼科杂志, 2017, 35(3): 233-238. doi:10.3760/cma.j.issn.2095-0160.2017.03.010 KONG Deqian, ZHENG Guangying, LI Li, et al. The proliferative inhibition and apoptosis promotion of Smac on human lens epithelial cells[J]. Chinese Journal of Experimental Ophthalmology, 2017, 35(3): 233-238. doi:10.3760/cma.j.issn.2095-0160.2017.03.010
[5] 马伊, 史建生, 罗维彬. 超声乳化术中前囊膜抛光预防后囊膜混浊的临床研究[J]. 眼科, 2001, 10(4): 207-209. doi:10.3969/j.issn.1004-4469.2001.04.004 MA Yi, SHI Jiansheng, LUO Weibin. Effect of polishing the anterior lens capsule during phacoemulsification in preventing the occurrence of posterior capsular opacification-a clinical study[J]. Petroleum Exploration and Development, 2001, 10(4): 207-209. doi:10.3969/j.issn.1004-4469.2001.04.004.
[6] Andjelic S, Drašlar K, Lumi X, et al. Morphological and proliferative studies on ex vivo cultured human anterior lens epithelial cells- relevance to capsular opacification[J]. Acta Ophthalmol, 2015, 93(6): e499-e506. doi:10.1111/aos.12655.
[7] Wormstone IM. The human capsular bag model of posterior capsule opacification[J]. Eye(Lond), 2020, 34(2): 225-231. doi:10.1038/s41433-019-0680-z
[8] Lin H, Ouyang H, Zhu J, et al. Lens regeneration using endogenous stem cells with gain of visual function[J]. Nature, 2016, 531(7594): 323-328. doi:10.1038/nature17181
[9] Wormstone IM, Wormstone YM, Smith AJO, et al. Posterior capsule opacification: what's in the bag? [J]. Prog Retin Eye Res, 2021, 82: 100905. doi:10.1016/j.preteyeres.2020.100905
[10] Wu W, Lois N, Prescott AR, et al. The importance of the epithelial fibre cell interface to lens regeneration in an in vivo rat model and in a human bag-in-the-lens(BiL)sample[J]. Exp Eye Res, 2021, 213: 108808. doi:10.1016/j.exer.2021.108808
[11] Daijiro K, Toshiyasu I, Junya K. Time course of lens epithelial cell behavior in rabbit eyes following lens extraction and implantation of intraocular lens[J]. J Ophthalmol, 2021, 2021: 6659838. doi:10.1155/2021/6659838
[12] Walker JL, Bleaken BM, Romisher AR, et al. In wound repair vimentin mediates the transition of mesenchymal leader cells to a myofibroblast phenotype[J]. Mol Biol Cell, 2018, 29(13): 1555-1570. doi:10.1091/mbc.E17-06-0364
[13] Lovicu FJ, Shin EH, McAvoy JW. Fibrosis in the lens. Sprouty regulation of TGFβ-signaling prevents lens EMT leading to cataract[J]. Exp Eye Res, 2016, 142: 92-101. doi:10.1016/j.exer.2015.02.004
[14] Mochizuki T, Luo YJ, Tsai HF, et al. Cell division and cadherin-mediated adhesion regulate lens epithelial cell movement in zebrafish[J]. Development, 2017, 144(4): 708-719. doi:10.1242/dev.138909
[15] Liu L, Xiao W. Notch1 signaling induces epithelial-mesenchymal transition in lens epithelium cells during hypoxia[J]. BMC Ophthalmol, 2017, 17(1): 135. doi:10.1186/s12886-017-0532-1
[16] Raghavan CT, Smuda M, Smith AJ, et al. AGEs in human lens capsule promote the TGFβ2-mediated EMT of lens epithelial cells: implications for age-associated fibrosis[J]. Aging Cell, 2016, 15(3): 465-476. doi:10.1111/acel.12450
[17] Boswell BA, Korol A, West-Mays JA, et al. Dual function of TGFβ in lens epithelial cell fate: implications for secondary cataract[J]. Mol Biol Cell, 2017, 28(7): 907-921. doi:10.1091/mbc.E16-12-0865
[18] Yu F, Ding XX, Li J, et al. Relationship of posterior capsular opacification and capsular bend type investigation based on swept-source optical coherence tomography[J]. Curr Eye Res, 2020, 45(1): 17-23. doi:10.1080/02713683.2019.1645183
[19] Xiao W, Chen X, Li W, et al. Quantitative analysis of injury-induced anterior subcapsular cataract in the mouse: a model of lens epithelial cells proliferation and epithelial-mesenchymal transition[J]. Sci Rep, 2015, 5: 8362. doi:10.1038/srep08362
[20] Apple DJ. Influence of intraocular lens material and design on postoperative intracapsular cellular reactivity[J]. Trans Am Ophthalmol Soc, 2000, 98: 257-283
[21] Findl O, Neumayer T, Hirnschall N, et al. Natural course of Elschnig pearl formation and disappearance[J]. Invest Ophthalmol Vis Sci, 2010, 51(3): 1547-1553. doi:10.1167/iovs.09-3989
[22] Sacu S, Menapace R, Findl O, et al. Influence of optic edge design and anterior capsule polishing on posterior capsule fibrosis[J]. J Cataract Refract Surg, 2004, 30(3): 658-662. doi:10.1016/j.jcrs.2003.07.005
[23] Neumayer T, Findl O, Buehl W, et al. Long-term changes in the morphology of posterior capsule opacification[J]. J Cataract Refract Surg, 2005, 31(11): 2120-2128. doi:10.1016/j.jcrs.2005.04.038
[24] Buehl W, Findl O, Neumayer T, et al. Short-term changes in the morphology of posterior capsule opacification[J]. J Cataract Refract Surg, 2005, 31(5): 962-968. doi:10.1016/j.jcrs.2004.08.051
[25] Neumayer T, Findl O, Buehl W, et al. Daily changes in the morphology of Elschnig pearls[J]. Am J Ophthalmol, 2006, 141(3): 517-523. doi:10.1016/j.ajo.2005.11.019
[26] Nguyen CL, Francis IC. Mechanical anterior lens capsule polishing under viscoelastic during phacoemulsification cataract surgery[J]. Clin Exp Ophthalmol, 2017, 45(6): 654-656. doi:10.1111/ceo.12924
[27] Borkenstein AF, Borkenstein EM, Malyugin B. Removing residual cortical material during cataract surgery: Visco polishing and the grindstone effect as a new surgical technique[J]. Eur J Ophthalmol, 2022, 32(3): 1817-1820. doi:10.1177/11206721211059909
[28] Mathey CF, Kohnen TB, Ensikat HJ, et al. Polishing methods for the lens capsule: histology and scanning electron microscopy[J]. J Cataract Refract Surg, 1994, 20(1): 64-69. doi:10.1016/s0886-3350(13)80046-6
[29] 朱嘉丽, 赵云鹤. 抛光前囊膜及赤道部在白内障超声乳化人工晶状体植入术中的应用[J]. 国际眼科杂志, 2017, 17(3): 482-484. doi:10.3980/j.issn.1672-5123.2017.3.23 ZHU Jiali, ZHAO Yunhe. Application of polishing anterior capsule and equator in phacoemulsification and intraocular lens implantation[J]. International Eye Science, 2017, 17(3): 482-484. doi:10.3980/j.issn.1672-5123.2017.3.23
[30] 邹大和. 白内障超声乳化术中前囊膜抛光预防患者后囊膜混浊的效果[J]. 临床医学研究与实践, 2020, 5(11): 116-117, 126. doi:10.19347/j.cnki.2096-1413.202011053 ZOU Dahe. Effect of anterior capsular polishing during phacoemulsification in preventing posterior capsular opacification of patients[J]. Clinical Research and Practice, 2020, 5(11): 116-117, 126. doi:10.19347/j.cnki.2096-1413.202011053
[31] Wang D, Yu X, Li Z, et al. The effect of anterior capsule polishing on capsular contraction and lens stability in cataract patients with high myopia[J]. J Ophthalmol, 2018, 2018: 8676451. doi:10.1155/2018/8676451
[32] Pollhammer M, Meiller R, Rummelt C, et al. In situ ablation of lens epithelial cells in porcine eyes with the laser photolysis system[J]. J Cataract Refract Surg, 2007, 33(4): 697-701. doi:10.1016/j.jcrs.2006.12.024
[33] Mamalis N, Grossniklaus HE, Waring, et al. Ablation of lens epithelial cells with a laser photolysis system: histopathology, ultrastructure, and immunochemistry[J]. J Cataract Refract Surg, 2010, 36(6): 1003-1010. doi:10.1016/j.jcrs.2009.11.021
[34] Luft N, Kreutzer TC, Dirisamer M, et al. Evaluation of laser capsule polishing for prevention of posterior capsule opacification in a human ex vivo model[J]. J Cataract Refract Surg, 2015, 41(12): 2739-2745. doi:10.1016/j.jcrs.2015.06.039
[35] Raut RM. Low-intensity ultraviolet A irradiation of the lens capsule to remove lens epithelial cells during cataract surgery. Effectiveness and safety[J]. J Cataract Refract Surg, 2007, 33(6): 1025-1032. doi:10.1016/j.jcrs.2007.02.026
[36] Wang D, Guo D, Bi H, et al. Zinc oxide nanoparticles inhibit Ca2+-ATPase expression in human lens epithelial cells under UVB irradiation[J]. Toxicol In Vitro, 2013, 27(8): 2117-2126. doi:10.1016/j.tiv.2013.09.015
[37] Humphry RC, Davies EG, Jacob TJ, et al. The human anterior lens capsule: an attempted chemical debridement of epithelial cells by ethylenediaminetetracetic acid(EDTA)and trypsin[J]. Br J Ophthalmol, 1988, 72(6): 406-408. doi:10.1136/bjo.72.6.406
[38] Maloof A, Neilson G, Milverton EJ, et al. Selective and specific targeting of lens epithelial cells during cataract surgery using sealed- capsule irrigation[J]. J Cataract Refract Surg, 2003,29(8): 1566-1568. doi:10.1016/s0886-3350(03)00058-0
[39] Zamora-Alejo K, Moore S, Leatherbarrow B, et al. Hyaluronidase toxicity: a possible cause of postoperative periorbital inflammation[J]. Clin Exp Ophthalmol, 2013, 41(2): 122-126. doi:10.1111/j.1442-9071.2012.02834.x
[40] Zhang RP, Xie ZG. Research progress of drug prophylaxis for lens capsule opacification after cataract surgery[J]. J Ophthalmol, 2020: 2181685. doi:10.1155/2020/2181685
[41] Sacu S, Menapace R, Wirtitsch M, et al. Effect of anterior capsule polishing on fibrotic capsule opacification: three-year results[J]. J Cataract Refract Surg, 2004, 30(11): 2322-2327. doi:10.1016/j.jcrs.2004.02.092
[42] Sachdev GS, Soundarya B, Ramamurthy S, et al. Impact of anterior capsular polishing on capsule opacification rate in eyes undergoing femtosecond laser-assisted cataract surgery[J]. Indian J Ophthalmol, 2020, 68(5): 780-785. doi:10.4103/ijo.IJO_1787_19
[43] Bang SP, Yoo YS, Jun JH, et al. Effects of residual anterior lens epithelial cell removal on axial position of intraocular lens after cataract surgery[J]. J Ophthalmol, 2018, 2018: 9704892. doi:10.1155/2018/9704892
[44] Menapace R, Wirtitsch M, Findl O, et al. Effect of anterior capsule polishing on posterior capsule opacification and neodymium: YAG capsulotomy rates: three-year randomized trial[J]. J Cataract Refract Surg, 2005, 31(11): 2067-2075. doi:10.1016/j.jcrs.2005.08.051
[45] Liu X, Cheng B, Zheng D, et al. Role of anterior capsule polishing in residual lens epithelial cell proliferation[J]. J Cataract Refract Surg, 2010, 36(2): 208-214. doi:10.1016/j.jcrs.2009.08.020
[46] Spalton DJ, Russell SL, Evans-Gowing R, et al. Effect of total lens epithelial cell destruction on intraocular lens fixation in the human capsular bag[J]. J Cataract Refract Surg, 2014, 40(2): 306-312. doi:10.1016/j.jcrs.2013.06.030
[47] Han R, Hao P, Wang L, et al. MicroRNA-34a inhibits epithelial-mesenchymal transition of lens epithelial cells by targeting Notch1[J]. Exp Eye Res, 2019, 185: 107684. doi:10.1016/j.exer.2019.05.024
[48] Wang J, Zhang J, Xiong Y, et al. TGF-β regulation of microRNA miR-497-5p and ocular lens epithelial cell mesenchymal transition[J]. Sci China Life Sci, 2020, 63(12): 1928-1937. doi:10.1007/s11427-019-1603-y
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