Natural evolution of Elschnig pearl posterior capsule opacification after posterior capsulotomy

Purpose: To study the natural evolution of Elschnig pearl posterior capsule opacification (PCO) after neodymium:YAG posterior capsulotomy. Setting. Instituto Oftalmologico Murciano, Murcia, Spain. Methods: This prospective study comprised 173 eyes that had a posterior cap sulotomy to treat Elschnig pearl PCO. Patients were included in the study a t different stages after posterior capsulotomy and followed using serial an terior segment photographs for 18 to 48 months. Results: During the first year after the capsulotomy, pearls proliferated a nd migrated toward the capsulotomy edge in 83% of the cases, leading to the formation of a collar-like ring of pearls around the capsulotomy. During t he second year, an increase in cells was observed in 45% of cases; in 45% o f eyes, there were fewer pearls. The amount of pearls decreased in 48%, 52% , and 26% of cases at 3, 4, and 5 years, respectively, and were completely gone in 6%, 17%, and 45%. After 5 years, 17% of eyes had a reduction in pea rls and 67% had no pearls. Conclusions: Elschnig pearl PCO is a self-limiting process. After posterior capsulotomy, cells proliferated and attempted to occlude the capsular open ing. Later, a reduction in the amount of cells was observed, leading to a c ompletely clear posterior capsule in most eyes. (C) 2001 ASCRS and ESCRS.