Effect of anterior capsular polishing on the rate of posterior capsule opacification: A retrospective analytical study

Abstract

Aim: To determine whether anterior capsule polishing during cataract surgery done by phacoemulsification has any effect on the rate of posterior capsule opacification.

Materials and methods: We conducted a 3 year retrospective analytical study at our hospital. The medical records of patients who underwent cataract extraction by phacoemulsification with foldable square edge hydrophilic PCIOL between April 2007 and March 2010 were reviewed. The study included 1009 eyes of 950 patients who underwent phacoemulsification with foldable square edge hydrophilic IOL in the bag implantation with anterior capsular polishing. The control group included 981 eyes of 957 patients in whom anterior capsular polishing was not done. Patients in the age group of 45-65 years with well dilating pupils were included in the study. They were evaluated at 1 week, 1 month and 1 year post-operatively. Exclusion criteria included glaucoma, shallow anterior chamber, uveitis, high myopia, pseudoexfoliation, diabetes mellitus, traumatic cataracts, posterior polar cataract, subluxated cataracts, previous ocular surgeries, patients allergic to dilating drops, and steroid intake. Intraoperatively, the exclusion criteria were not achieving the total anterior capsule cover on the IOL optic, sulcus fixated IOL, and any intraoperative complications like posterior capsule rupture. After bimanual irrigation/aspiration, all enrolled patients were randomly assigned to receive either 360 degree anterior capsular polishing or No anterior capsular polishing and results were studied.

Results: The rate of posterior capsule opacification in the study group and in the control group was not statistically significant.

Conclusion: Though it was thought that anterior capsular polishing will lead to reduced rate of PCO formation, our study showed that there was no significant difference in PCO formation between the two groups. However, it was seen that the rate of anterior capsule opacification and capsular phimosis showed a significant reduction in cases in which anterior capsular polishing was done.

Keywords: Anterior capsular polishing; Phacoemulsification; Posterior capsular opacification.

Figure 1

Posterior capsular opacification.

Figure 2

Eyes showing various forms of capsular opacification. (A) Extensive anterior capsular opacification; (B) mixed type of opacification with fibrous (arrow) and pearl type areas (asterisk); (C) fibrous form of posterior capsular opacification (arrow); (D) proliferative or pearl form (asterisk); (E) linear posterior capsular opacification.

Figure 3

IOL design.

Figure 4

Square edge of IOL.