Capsular bending ring to prevent posterior capsule opacification: 2 year follow-up

Purpose., To evaluate the preventive effect of a capsular bending ring on a nterior and posterior capsule (PCO) opacification in a 2 year clinical stud y. Setting. Jinshikai Medical Foundation, Nishi Eye Hospital, Osaka, Japan. Methods: This study comprised 60 patients with senile cataract (35 women, 2 5 men) with a mean age of 69 years. An open poly(methyl methacrylate) capsu lar bending ring with a truncated edge profile designed to create a sharp b end in the equatorial capsule was implanted in 1 eye of patients with a hyd roxyethyl methacrylate intraocular lens (IOL). The contralateral eye, which acted as a control, received an [OL but no ring. Patients were examined 6 months (n = 52), 1 year (n = 48), and 2 years (n = 42) postoperatively. Ant erior capsule opacification was determined by slitlamp evaluation. Anterior capsule shrinkage (area within the capsulorhexis) and PCO were evaluated a nd scored using a computer software package for image analysis. Posterior c apsule opacification was also measured by the rate of neodymium:YAG (Nd:YAG ) capsulotomies. Results: Anterior capsule opacification and shrinkage were significantly le ss in eyes with the ring. The mean PCO score was 0.235 +/- 0.215 (SD), 0.28 7 +/- 0.200, and 0.398 +/- 0.248 with the ring and 0.530 +/- 0.190, 0.670 /- 0.225, and 1.111 +/- 0.298 without the ring at 6 months, 1 year, and 2 y ears, respectively (P < .01 at each follow-up). An Nd:YAG laser capsulotomy was performed in 4 eyes with and 17 eyes without the ring after 2 years (P < .01). Conclusions: The capsular bending ring significantly reduced anterior capsu le fibrosis and shrinkage as well as PCO, The ring may be useful in patient s who are at high risk of developing eye complications from capsule opacifi cation that require Nd:YAG laser capsulotomy, in those expected to have vit reoretinal surgery and photocoagulation, and in cases of pediatric cataract . (C) 2001 ASCRS and ESCRS.