Polishing the Anterior Capsule Appears Unrelated to Opacification Risk: An Eye Doctor’s Perspective

Polishing the Anterior Capsule Appears Unrelated to Opacification Risk: An Eye Doctor’s Perspective

Capsular bending is a phenomenon observed in the aftermath of a cataract surgery. The anterior capsule gets attached to the front surface of the intraocular lens (IOL) which eventually leads to both the anterior and posterior capsules sticking together until they reach the IOL’s edge. The posterior capsule then encircles the edge of the IOL, forming a capsular bend. A study was conducted to observe the impact of the anterior capsule polishing on the formation of the capsular bend, as well as on postoperative anterior and posterior capsule opacification (ACO and PCO respectively) following age-related cataract surgeries.

The study was conducted in a prospective and comparative manner. A group of 21 patients ranging from 56 to 84 years old, all with normal axial length, were enrolled. Each patient had two eyes undergoing the same standard cataract surgery, but one eye received anterior capsule polishing while the other did not. The key outcomes measured included the occurrence and intensity of ACO, as well as the clarity of the capsular bend during a specified postoperative period. Evaluation methods included slit-lamp examinations and photographic analysis.

The results showed significant divergences in the capsular bend index between the polished eyes and the control eyes at different postoperative stages: week 1, month 1, month 6, and month 12. The anterior capsular opening area also exhibited significant differences. However, the ACO or PCO rates didn’t show any variations between the two groups at any point in time.

However, the study had some limitations. The relatively small sample size and the short follow-up period may limit the broad applicability of the results and prevent a thorough analysis of the long-term effects of anterior capsule polishing on ACO, PCO, and capsular bend. Additionally, the lack of diversity in the patient population, particularly the absence of patients with significant ocular comorbidities, could limit the relevance of the findings to a wider group. Lastly, the subjective nature of the assessments for evaluating capsule opacification and bend quality may lead to observer bias.

Until now, the effect of anterior capsule polishing on ACO and capsular bend wasn’t well defined. This study suggests that anterior capsule polishing could be advantageous in conditions like uveitic cataracts, pseudoexfoliation syndrome, and small capsulorrhexis cases, as it may help decrease the rate of anterior capsular contraction syndrome. However, more research is required to verify these findings and conclusively determine the technique’s effectiveness in these specific cases.

Financial Disclosures: No financial relationships have been disclosed by Dr. Nisarg Chhaya.

Dr. Navin Kumar Gupta
http://shankarnetrika.com

Director, Shankar Netrika Medical Retina Specialist Retina Fellow, University of California, Irvine, USA (2008-2010) Research Fellow, Johns Hopkins Hospital, Baltimore, USA (2007-2008) Anterior Segment Fellow, Aravind Eye Hospital, Madurai (2004-2006) Affiliate of SEE International, Santa Barbara, USA Collaborator and Advisor of Phaco Training Program, Anjali Eye Center

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