Posterior capsular opacification after cataract surgery

This is a review of the current status of clinical research on the preventi on of posterior capsular opacification (PCO), which is now the commonest co mplication of cataract surgery occurring in up to 50% of patients by 2 to 3 years after the operation. PCO is caused by lens epithelial cells retained in the capsular bag following surgery which then proliferate, migrate and transform to myofibroblasts. Interest in the prevention of PCO has centred around surgical technique, pharmacological methods to remove or destroy len s epithelial cells and changes in intraocular lens material and design. Cha nges in surgical technique have little effect in prevention of PCO although a capsulorhexis size which lies on the optic diameter appears to be benefi cial. Many different cytotoxic drugs and pharmacological agents have been u sed experimentally to prevent PCO but the problem has limited damage only t o lens epithelial cells. So far, no method has been shown to be safe for cl inical use. Current interest is centred once again on the intraocular lens itself, particularly the material that ii is made from and changes in its e dge profile.