Safety and efficacy of Nd:YAG laser capsulotomy in management of posterior capsular opacification

Background: At present, the only effective treatment of posterior capsular opacification (PCO), which is the most common complication of modern cataract surgery, is Neodymium-Yttrium Aluminum Garnet (Nd:YAG) laser capsulotomy. There are few complications associated with this easy and quick laser capsulotomy. The current study was conducted in a tertiary hospital of Odisha with an objective to find the safety and efficacy of Nd:YAG laser capsulotomy in the management of defective vision due to posterior capsular opacity.Methods: The study was conducted among the patients attending the Ophthalmology out patient department of a tertiary hospital in Odisha with defective vision due to posterior capsular opacity after cataract surgery. Nd:YAG laser capsulotomy was carried out in all patients with significant PCO. Visual acuity and intraocular pressure were recorded before and after the procedure. The cases were carefully followed up and looked for any complication and visual acuity was assessed during follow up visits.Results: In the study 184 participants were included. Visual improvement was observed in 97.8% participants. Visual acuity improved to 6/6 in 21.73 %, 6/9 in 36.41 % cases, 6/12 in 15.21 % cases. Raised IOP was recorded among 46% of participant after 4 hrs of laser capsulotomy which was later observed among 12% of participants on follow up visit at 1 week. The most common complication recorded was transient rise of IOP (46.3%) followed by aqueous flare (28.8%).Conclusions: Nd:YAG laser capsulotomy is a noninvasive, effective, relatively safe procedure for PCO with good visual outcome.

Comparison of Ocular Aberration and Clinical Outcome between Different Aspheric Intraocular Lenses in Both Eyes

PURPOSE: We compared the ocular aberration and clinical outcome between different aspheric intraocular lenses (IOL) in both eyes. METHODS: This prospective randomized controlled study was comprised of patients with bilateral cataract who received two different aspheric IOLs implanted in both eyes: negatively aspheric Tecnis® ZCB00 and spherically neutral Akreos® MI60. Total and corneal aberrations computed by Wavescan® and Pentacam® were assessed at 6 months to investigate the effects of the IOL's spherical aberration on the eye and to analyze the incidence and degree of posterior capsule opacification. By using spherical aberration of the cornea and the IOLs, values calculated via Ray-tracing software and Wavescan® were compared. Total spherical aberration was analyzed by the MATLAB program and converting the pupil size to 6.0, 4.5, 3.0 mm. RESULTS: A total of 25 patients were included. Regarding pre-operative corneal aberration, ZCB00 group was 0.232 ± 0.119 µm while MI60 group was 0.240 ± 0.117 µm, and there was no difference between the two IOLs. At 6 months after total ocular spherical aberration, MI60 group (pupil size 6.0 mm; 0.296 ± 0.097 µm, 4.5 mm; 0.094 ± 0.032 µm, 3.0 mm; 0.019 ± 0.006 µm) had more positive values than ZCB00 group (pupil size 6.0 mm; 0.051 ± 0.105 µm, 4.5 mm; 0.009 ± 0.034 µm, 3.0 mm; 0.002 ± 0.007 µm) (p < 0.001). When calculated using the ray tracing method, based on the results after surgery, MI60 group's total spherical aberrations were higher than ZCB00 group. However, from 1 month to 6 months after surgery, the uncorrected distance visual acuity, spherical equivalent and posterior capsule opacification showed no differences between the two IOLs. CONCLUSIONS: In eyes with aspheric IOLs with negative spherical aberration, spherical aberration was lower than spherically neutral aspheric IOLs. Regarding postoperative visual acuity, spherical equivalent and posterior capsule opacification, there were no significant differences between the two groups.

Update of pediatric cataract surgery complications / 中华实验眼科杂志

The procedures of pediatric cataract surgery are much complicated than those in adults.The ocular anatomy of children is special and the morphology of the cataract usually require alternative surgical techniques.The complications of pediatric cataract are common and the follow-up is extensive.Vision restoration needs long process which require parental dedication.These factors make the treatments of pediatric cataract challenging.Recently,the update on pediatric cataract surgery complications includes:the use of 23-gauge and 25-gauge vitrectors in pediatric cataract surgery allow for potentially sutureless technique.Infant Aphakia Treatment Study (IATS),which is a multicenter,randomized,clinical trial comparing cataract surgery with or without intraocular lens (IOL) implantation in infants,has reported series of early stage and medium-long term outcomes;large population and long term retrospective study showed the new survey in bleeding,endophthalmitis and glaucoma-relative adverse events,visual axis opacities,and retinal detachment (RD) after pediatric cataract surgery.Complications of pediatric cataract were elucidated in this review in order to help the ophthalmologists to understand them.

Applications of capsular bag model in posterior capsular opacification / 中华实验眼科杂志

Posterior capsular opacification (PCO),also known as after-cataract,is the most frequent complication and the primary cause for visual decrease after extracapsular cataract surgery.At present,there is no effective way to treat PCO,so more attentions are focused on preventive reseaching of PCO and treatment methods.Although a variety of studies have increased our understanding of the pathogenesis of PCO,the cellular mechanisms responsible for PCO are still unclear.Cultured capsular bag model in vitro could effectively simulate lens capsular membrane and cells survival environment after cataract extraction and IOL implantation.However,lens capsular bag cultivation with different methods have their own characreristics.The material source,preparation methods of capsular bag model,characreristics of materials which maintain capsular bag contours and its application in PCO were reviewed.

Manuel’s asteroid disruption technique.

A seventy-year-old male presented with dense asteroid hyalosis in both eyes. He had undergone cataract extraction in one eye 3 years ago, and the other eye had immature cataract. Both the autorefractor and dilated streak retinoscopy did not give readings and subjective visual improvement could not be achieved. Immediately following YAG posterior capsulotomy and anterior vitreous asteroid disruption, the vision improved to 20/20 with recordable auto refractor and streak retinoscopy values. Our initial experience indicates that the treatment is simple, safe and effective but needs controlled and prospective studies to confirm its long-term safety.

Comparison of Nd:YAG Laser Capsulotomy Rates between Implantation of Two Different Aspheric Intraocular Lenses

PURPOSE: To compare neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy rates between 2 different aspheric intraocular lenses, SN60WF and MI-60, in patients who underwent cataract surgery. METHODS: This retrospective study included 404 eyes of 278 patients who were followed up for at least 6 months after cataract surgery. Gender, age, follow-up period and Nd:YAG laser capsulotomy rates between the 2 different intraocular lens groups were compared. RESULTS: The mean follow-up period was 28.1 months in the SN60WF group and 24.3 months in the MI-60 group and the mean age was 68.6 years and 71.3 years in each group, respectively. Follow-up period and age were significantly different between the 2 groups (p < 0.01). Nd:YAG laser capsulotomy rates were 5.6% (13 of 231 eyes) in the SN60WF group and 48% (83 of 173 eyes) in the MI-60 group. Nd:YAG laser capsulotomy rates were significantly higher in the MI-60 group (p < 0.01). Female gender and young age were associated with significantly increased Nd:YAG laser capsulotomy rates (p < 0.01); however, diabetes mellitus was not significantly associated with Nd:YAG laser capsulotomy rates. CONCLUSIONS: Nd:YAG laser capsulotomy rates were higher in the MI60 hydrophilic aspheric intraocular lens group than the SN60WF hydrophilic aspheric intraocular lens group.

Assessment of Posterior Capsular Opacification of Korean Using Straylight and Glare Sensitivity Meter

PURPOSE: To evaluate posterior capsular opacity (PCO) using straylight and glare sensitivity meter and to compare availability of straylight and glare sensitivity with known methods for PCO evaluation. METHODS: Thirty-six pseudophakic eyes with PCO were selected for this study. Best-corrected visual acuity (BCVA), straylight (C-quant, Oculus GmbH, Wetzlar, Germany) and glare sensitivity (Binoptometer, Oculus GmbH, Wetzlar, Germany) were measured before mydriasis. After mydriasis, PCO images were captured with a slit-lamp and analyzed using the Evaluation of Posterior Capsular Opacification (EPCO) program (EPCO software, University of Heidelberg, Heidelberg, Germany). The same measurements were taken after capsulotomy and compared with pre-capsulotomy data. RESULTS: After capsulotomy, BCVA, EPCO score and straylight were improved with statistical significance (p < 0.05). Cases of PCO with mildly decreased visual acuity showed statistically significantly improved EPCO score and straylight (p < 0.05). Glare sensitivity did not show significant improvement but was statistically significantly correlated with straylight (p = 0.023, Rho = 0.732). CONCLUSIONS: Straylight is an available measurement for evaluation of PCO. Glare sensitivity meter which correlates with straylight can be used as a supportive measurement.

Assessment of Posterior Capsular Opacification of Korean Using Straylight and Glare Sensitivity Meter

PURPOSE: To evaluate posterior capsular opacity (PCO) using straylight and glare sensitivity meter and to compare availability of straylight and glare sensitivity with known methods for PCO evaluation. METHODS: Thirty-six pseudophakic eyes with PCO were selected for this study. Best-corrected visual acuity (BCVA), straylight (C-quant, Oculus GmbH, Wetzlar, Germany) and glare sensitivity (Binoptometer, Oculus GmbH, Wetzlar, Germany) were measured before mydriasis. After mydriasis, PCO images were captured with a slit-lamp and analyzed using the Evaluation of Posterior Capsular Opacification (EPCO) program (EPCO software, University of Heidelberg, Heidelberg, Germany). The same measurements were taken after capsulotomy and compared with pre-capsulotomy data. RESULTS: After capsulotomy, BCVA, EPCO score and straylight were improved with statistical significance (p < 0.05). Cases of PCO with mildly decreased visual acuity showed statistically significantly improved EPCO score and straylight (p < 0.05). Glare sensitivity did not show significant improvement but was statistically significantly correlated with straylight (p = 0.023, Rho = 0.732). CONCLUSIONS: Straylight is an available measurement for evaluation of PCO. Glare sensitivity meter which correlates with straylight can be used as a supportive measurement.

Incidence and Risk Factors of Nd:YAG Capsulotomy in Adult Cataract Patients Younger than 50 Years of Age

PURPOSE: To evaluate the cumulative incidence and estimate the risk factors of Nd:YAG capsulotomy due to posterior capsular opacification in adult cataract patients younger than 50 years of age. METHODS: In the present study we retrospectively reviewed 118 consecutive eyes that received phacoemulsification and intraocular lens implantation. We analyzed the cumulative incidence of Nd:YAG posterior capsulotomy and the associated risk factors. RESULTS: The cumulative incidence of posterior capsulotomy was 4.24%, 5.08%, 8.47%, 15.25%, and 20.34% in adults younger than 50 years of age at 3 months, 6 months, 12 months, 24 months, and more than 24 months after cataract surgery, respectively. The nuclear type (p = 0.021) and the mature type (p = 0.014) cataract groups were strongly associated with an increased risk of posterior capsulotomy compared with the posterior subcapsular type. The hydrophobic and single-piece intraocular lens caused the lowest incidence of posterior capsulotomy among intraocular lenses used for cataract surgery (p = 0.028). The subgroup analysis showed no statistical significance between gender, existence of diabetic mellitus or glaucoma, intraocular lens haptic material and the risk of posterior capsulotomy (p > 0.05). CONCLUSIONS: The cumulative incidence of Nd:YAG capsulotomy was 20.34% in adults younger than 50 years of age and at more than 24 months after cataract surgery. The risk factors associated with posterior capsulotomy included nuclear and mature cataract types. Additionally, there was a difference in the incidence of posterior capsulotomy according to the type of intraocular lenses.

Incidence, indications, and outcomes of Yag Capsulotomy in eyes Implanted with an accommodating intraocular lens

Objectives@#To do report the incidence of capsular changes in Crystalens-implanted eyes and analyze the indications and outcomes of yag capsulotomy. @*Methods@#We reviewed the records of 411 eyes of 258 patients implanted with the Crystalens IOL. Capsular change indications for yag capsulotomy were posterior capsular opacification (PCO), lens tilt, and capsular striae. Eyes in each indication were further subdivided into therapeutic yag (TY) and prophylactic yag (PY) groups. Outcomes before and after yag capsulotomy were analyzed. @*Results@#Ninety of 411 crystalens-implanted eyes (22%) had undergone yag capsulotomy. Sixty-one eyes had PCO, 12 had lens tilt, and 17 had striae. Twenty-seven eyes belonged to the therapeutic (TY) and 63 eyes to the prophylactic (PY) yag subgroups. The mean interval between phacoemulsification and yag capsulotomy was 10 months. In the TY PCO subgroup, uncorrected distance visual acuity (UDVA) changed from 20/40 pre-yag to 20/25 post-yag, uncorrected near visual acuity (UNVA) from J3 to J2, manifest refraction spherical equivalent (MRSE) from -0.43D to -0.2D. In the TY tilt subgroup, UDVA changed from 20/50 to 20/30, UNVA was unchanged at J2, and MRSE from -1.21D to -0.89D. In the TY striae group, UDVA changed from 20/50 to 20/30, UNVA from J3 to J2, and MRSE from 0.62D to -0.4D. In the PY PCO subgroup, UDVA was unchanged at 20/25, UNVA unchanged at J2, and MRSE changed from -0.52D to -0.47D. In the PY tilt subgroup, UDVA changed from 20/25 to 20/20, UNVA unchanged at J2, and MRSE changed from -0.87D to -0.45D. In the PY striae subgroup, UDVA was unchanged at 20/30, UNVA changed from J3 to J2, and MRSE changed from -0.62D to -0.7D. @*Conclusion@#Capsular changes occurred after Crystalens implantation that necessitated yag capsulotomy. Once vision has deteriorated, a therapeutic yag treatment can help improve vision. If capsular changes have occurred but vision has not deteriorated, a prophylactic yag capsulotomy can stabilize visual and refractive outcomes.

Complicaciones de la capsulotomía posterior por láser de Nd-Yag en el Centro Oftalmológico "Enrique Cabrera" de La Habana / Complications of posterior capsulotomy due to Nd-Yag laser in "Enrique Cabrera" Ophthalmological Center from Havana

Introducción: La opacidad capsular posterior es la complicación más frecuente de la cirugía de catarata y, aunque la capsulotomía con láser de Nd-Yag es un procedimiento muy efectivo para solucionarla, no está exenta de complicaciones.Objetivo: Describir las complicaciones en pacientes expuestos a capsulotomía con láser de Nd-Yag.Métodos: Se realizó un estudio descriptivo y prospectivo de 104 pacientes con opacidad capsular posterior, atendidos en el Centro Oftalmológico "Enrique Cabrera" de la Habana, durante el 2010. Se analizaron las variables frecuencia y tipo de complicaciones, edad, sexo, antecedentes patológicos personales oculares y sistémicos, clasificación de la opacidad capsular, energía utilizada, así como agudeza visual antes y después del tratamiento.Resultados: En la casuística predominaron el aumento de la presión intraocular y el edema macular quístico como las complicaciones más comunes, los pacientes de 56-75 años, el sexo femenino, así como la opacidad capsular fibrótica y la capsulotomía con más de 8,0 MJ.Conclusiones: Más de la mitad de los afectados presentaron complicaciones de carácter transitorio y reversible, las cuales no estuvieron relacionadas con la cantidad de energía empleada; la mejoría visual después del proceder fue notable.

Introduction: The posterior capsular opacity is the most frequent complication in the cataract surgery and, although capsulotomy with Nd-Yag laser is a very effective procedure to solve it, it is not free of complications. Objective: To describe the complications in patients exposed to capsulotomy with Nd-Yag laser.Methods: A descriptive and prospective study of 104 patients with posterior capsular opacity, assisted in "Enrique Cabrera" Ophthalmological Center from Havana, was carried out during the 2010. Variables of frequency and type of complication, age, sex, pathological ocular and systemic medical history, classification of the capsular opacity, energy used, as well as visual acuity before and after the treatment were analyzed.Results: The increase of the intraocular pressure and the cystic macular edema as the most common complications, the 56-75 year-old patients, female sex, as well as the capsular fibrotic opacity and the capsulotomy with more than 8,0 MJ prevailed in the case material.Conclusions: More than half of the patients presented complications of transitory and reversible type, which were not related to the quantity of energy used; the visual improvement after the procedure was remarkable.

"Paying attention to lens regeneration and research of ""lens stem cell"" in mammal" / 中华实验眼科杂志

With the existence of capsules,lens regeneration occurs in some mammals after extracapsular lens extraction.It is usually thought that lens regenerates from resident lens epithelial cells (LECs) in the capsule.However,lens regeneration dose not mean simple redupilication of development,and transparency of the lens is affected by irregular growth,migration and transdifferention of the resident LECs.Previous studies mainly focus on the dysplasia of LECs,but update theory about lens regeneration is proposed to be associated with stem cells.Some views and suggestions in lens regeneration are concerned in current researches to better illuminate the mechanism and therapy of posterior capsular opacity.

Influence of RGDRGD peptide on proliferation and adhesion of human lens epithelial cells in vitro / 中华实验眼科杂志

Background RGD is a small molecular multiple peptide containing Arg-Gly-Asp with an important role in inhibiting the adhesion,migration and neovascularization of tumor.Our previous study determined that RGD can suppress the adhesion and proliferation of lens epithelial cells(LECs),and RGDRGD may be of a stronger effect. Objective Present study was to investigate and compare the effect of RGDRGD peptide on the proliferation and adhesion of immortalized human LECs(HLEB-3)in vitro. Methods Human LECs harvested by trpsin-EDTA were suspended in DMEM medium with serial dilutions of RGD peptide and RGDRGD peptide(from 1000 mg/L to 250 mg/L)at 37℃ for 15 minutes as experimental group,and the HLECs cultured by common culture medium were used as the control group.The cells were then seeded into the 96-well plates with precoated fibmnectin (FN)and I collagen at the density of 2×104/ml.MTT stainingcolorimetry was used to measure the adhesion rates of lens epithelial cells cultured in different concentrations RGDRGD and RGD peptides after 1 hour.Cells were seeded into the 96-well plates for 24 hours at 37℃ in 5% CO2.Medium was then replaced with DMEM overnight.Subsequently,the cells were treated with serial dilutions of RGD and RGDRGD(from 2000 mg/L to 250 ms/L)dissolved in DMEM medium plus 20% fetal bovine serum.The inhibition of RGDRGD and RGD on the adhesion and proliferation of Human LECs was analyzed by MTT aher 24,48 and 72 hours. Results The inhibition rate of RGD peptide on the adhesion of LECs was gradually enhanced with the increase of concentration with the significant difference among the different concentrations groups(F=1089.56,P＜0.01),and the statistically significant elevation in inhibitory rate was found in RGDRGD peptide compared with RGD peptide(P＜0.01).The inhibition rate of RGDRGD peptide on the proliferation of LECs wag gradually increased with the increase of concentration with the significant difference among the different concentrations groups with a strongest effect in 1000 ms/L group(F=127.31,P＜0.01),and the much stronger inhibition Wag Been in RGDRGD peptide(F=1589.85,P＜0.01).The suppression rate of RGDRGD on LECs proliferation Wag much stronger with the prolong of time(F=1606.43,P＜0.01). Conclusion RGDRGD peptide and RGD peptide have inhibitory effect on adhesion and proliferation of human LECs in a dose-and time-dependent manner.Effect of RGDRGD peptide is much stronger than RGD peptide.These results imply that RGDRGD peptide and RGD peptide have the important role for prevention of PCO.

Frequency and distribution of various posterior capsular opacities post cataract extraction / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the frequency and distribution of various types of post cataract surgery and intraocular lens (IOL) implantation posterior capsular opacity (PCO) in hospitals.METHODS: This cross sectional, observational and descriptive study included 200 patients, 123 male and 77 female aged between 43 and 77(mean age 62.4) years, referring for cataract procedure from 2003 till 2007. The mean follow-up period of patients was 23 (range from 16 to 60) months. Data were gathered during follow-up time via a questionnaire and entered in a computer using SPSS software. Analysis was performed using ANOVA and Chi-Square tests. RESULTS: The various types of PCO included, fibrotic (63%), residual epithelial proliferative cells (15%) and mixed type (22%). The mean time period for development of postoperative decreased visual acuity due to PCO was 19.3(range from 3 to 48) months, younger patients had a significantly better vision post cataract surgery (P=0.0001), but the incidence of PCO was also more in them. In the older age group, fibrotic PCO was significantly more, while mixed type of opacities were the least prevalent (P=0.016). CONCLUSION: The present study did not determine any specific risk factors for development of PCO, and the most common type was fibrosis, all of the cases experienced both qualitative and quantitative decrease in vision and some of them required treatment with YAG Laser capsulotomy which is relatively expensive and has its own complications.

Pars Plana Vitrectomy Combined With Surgical Removal of Anterior and Posterior Capsular Opacity

PURPOSE: To evaluate the efficacy and intraocular lens (IOL) stability of vitrectomy combined with the surgical removal of anterior capsular opacity (ACO) and posterior capsular opacity (PCO). METHODS: Forty-four pseudophakic eyes of 43 patients with retinal disorders underwent vitrectomy with surgical removal after cataract diagnosis. Nineteen eyes of 19 patients (group 1) had ACO and PCO removed while 25 eyes of 24 patients (group 2) had only PCO removed. Total removal of the entire lens capsule, except for the area around the haptics, was performed when capsular opacity with fibrosis was observed around the capsulorrhexis margin. LogMAR best corrected visual acuity (BCVA), intraoperative complications and postoperative complications were compared. RESULTS: The retina was flat and postoperative BCVA improved in both groups. Intraoperative complications of IOL dislocation occurred in 3 eyes (15.8%) in group 1 and in 1 eye (4.0%) in group 2 (p=0.178). Among the 4 IOLs, 3 were open-loop haptic IOLs and 1 was a closed-loop haptic IOL. Late postoperative complications of IOL capture occurred in 1 eye (5.3%) in group 1. CONCLUSIONS: Removal of ACO and PCO for better visualization of the peripheral retina resulted in an improved visual recovery while intraoperative complications and postoperative complications were comparable to PCO removal alone. Removal limited to the optic zone would be more stable when considering any adhesion between the lens capsule and the IOL.

The Effectiveness of Tranilast in the Prevention of Posterior Capsular Opacity

PURPOSE: To evaluate the inhibitory effect of tranilast on the formation of posterior capsular opacity (PCO) after a cataract operation ex vivo and in a rabbit model. METHODS: A human lens epithelial cell line (B3) was treated with 0.005-0.1 mM tranilast. Cytotoxicity assessment and effective dosage determination of tranilast were performed using MTT assays. B3 cell lines were cultured in Eagle's minimal essential medium (EMEM) containing 20% FBS with different concentrationsof tranilast, and morphological differences were observed. To investigate the effect of tranilast on cytokine production in B3 cell lines, cells were treated with 0.01 mM tranilast and expression profiles of cytokines were analyzed by RT-PCR. After performing phacoemulsification and intraocular lens implantation in 10 white rabbits, 0.5% tranilast eye drops were given 4 times per day, and the severity of PCO was evaluated bi-weekly using POCOman for 8 weeks after the operation. RESULTS: Cell death was observed in the 0.05 mM tranilast-treated B3 cell lines, and inhibition of epithelial-mesenchymal transition (EMT) was also observed in the 0.01 mM tranilast-treated B3 cell lines. TGF-beta1/2, IL-18, and CDK7 mRNA expression decreased in the 0.01 mM tranilast-treated B3 cell lines. Significant suppression of PCO formation was observed in rabbits treated with 0.5% tranilast eye drops 5 weeks post operative (p<0.05). CONCLUSIONS: The results from this study show that tranilast suppresses EMT through inhibition of TGF-beta, IL-18,and CDK7 expression. The results suggest that tranilast can be used toprevent PCO formation after cataract surgery.

The Effectiveness of Tranilast in the Prevention of Posterior Capsular Opacity

PURPOSE: To evaluate the inhibitory effect of tranilast on the formation of posterior capsular opacity (PCO) after a cataract operation ex vivo and in a rabbit model. METHODS: A human lens epithelial cell line (B3) was treated with 0.005-0.1 mM tranilast. Cytotoxicity assessment and effective dosage determination of tranilast were performed using MTT assays. B3 cell lines were cultured in Eagle's minimal essential medium (EMEM) containing 20% FBS with different concentrationsof tranilast, and morphological differences were observed. To investigate the effect of tranilast on cytokine production in B3 cell lines, cells were treated with 0.01 mM tranilast and expression profiles of cytokines were analyzed by RT-PCR. After performing phacoemulsification and intraocular lens implantation in 10 white rabbits, 0.5% tranilast eye drops were given 4 times per day, and the severity of PCO was evaluated bi-weekly using POCOman for 8 weeks after the operation. RESULTS: Cell death was observed in the 0.05 mM tranilast-treated B3 cell lines, and inhibition of epithelial-mesenchymal transition (EMT) was also observed in the 0.01 mM tranilast-treated B3 cell lines. TGF-beta1/2, IL-18, and CDK7 mRNA expression decreased in the 0.01 mM tranilast-treated B3 cell lines. Significant suppression of PCO formation was observed in rabbits treated with 0.5% tranilast eye drops 5 weeks post operative (p<0.05). CONCLUSIONS: The results from this study show that tranilast suppresses EMT through inhibition of TGF-beta, IL-18,and CDK7 expression. The results suggest that tranilast can be used toprevent PCO formation after cataract surgery.

Clinical Outcomes of Surgical Techniques in Congenital Cataracts

PURPOSE: To investigate the general clinical features of congenital cataracts and to determine their relationship to visual prognosis and surgical complications according to age at operation and surgical procedure adopted. METHOD: We retrospectively evaluated 92 eyes in 61 patients with congenital cataracts who underwent cataract surgery between January 1996 and December 2006. The demographic data, surgical technique, post-operative complications, and final visual prognosis were evaluated. RESULTS: The average age at surgery was 3.17 years (range 1 month to 11 years), and the mean follow-up was 40.02 months (range 6 to 46 months). Of the 56 eyes that could be checked for visual acuity after cataract extraction, 29 (51.7%) had a BCVA of > or =0.5 at last visit. Unilateral congenital cataracts (p=0.025) and congenital cataracts with strabismus (p=0.019) showed significantly poorer visual outcomes. Patients with nystagmus also experienced a poor visual outcome; 6 patients (67%) had a BCVA of <0.1. Posterior cataracts had the worst visual prognosis (p=0.004). No statistically significant differences in posterior capsular opacity (p=0.901) or synechia formation (p=0.449) were observed between surgical techniques, but children younger than one year showed a higher tendency for PCO and synechia formation. CONCLUSIONS: Anterior vitrectomy did not reduce postoperative complications. Higher rates of complications (PCO, posterior synechia) developed in children younger than one year of age.

The Factors Affecting Early Development of Posterior Capsular Opacification after Cataract Surgery

PURPOSE: To identify factors affecting early development of posterior capsular opacity after cataract surgery. METHODS: The medical records of patients who had undergone phacoemulsification and intraocular lens implantation with the same surgeon from January 1997 to May 2003 were reviewed. This study recruited 3625 eyes. Age, sex, systemic diseases, preoperative visual acuity, and intraocular lens materials were compared between the early capsulotomy group (Group 1, where the interval from cataract surgery to capsulotomy or =3 years, 39 eyes). RESULTS: The mean age for Group 1 was 56.76+/-15.96 years and that for Group 2 was 61.97+/-13.46 years (p=0.125, Student t-test). No significant differences were seen between Group 1 and Group 2 with respect to diabetes or hypertension (p=0.166 and p=0.109, Pearson's chi-square test). There was a significant difference in intraocular lens materials between Group 1 and Group 2 (p=0.002, Pearson's chi-square test), and significantly fewer eyes with PMMA lenses than with silicone or acrylate lenses in Group 1 (p=0.001 and p=0.005, Pearson's chi-square test). CONCLUSIONS: The number of eyes with PMMA lenses was significantly smaller than the number with silicone or acrylate lenses in the early capsulotomy group. This suggests that PMMA intraocular lenses may induce posterior capsular opacity later in the postoperative period than silicone or acrylate lenses.

Effect of Polyethylene Glycol Polymerization onto a Foldable Intraocular Lens in Pathogenesis of Posterior Capsular Opacity

PURPOSE: To investigate the effect of polyethylene glycol (PEG)-grafted acryl intraocular lenses on the prevention of posterior capsular opacification (PCO). METHODS: The acrylic surface of an intraocular lens (Acrysof SA 60AT, Alcon) was polymerized with PEG (PEG-IOL). To investigate the degree of cell adhesion to the modified lens surface, human lens epithelial cells (1x10(4) cells/ml) were inoculated on each PEG-grafted and acrylic control lens, and all were cultured in a carbon dioxide incubator for 24 hours. The adhered cells were trypsinized and counted. The PEG-IOL was implanted in 20 New Zealand rabbits after removal of the crystalline lens. The formations of PCO were checked serially through retroilluminated digital photography and severity scores were calculated using POCOman. The cell adherence pattern on the PEG-grafted IOL was examined by scanning electron microscopy. RESULTS: The mean number of adherent cells in PEG-IOL was 3.2+/-1.1x10(3), which tended to be smaller than that of the unmodified acrylic control (3.6+/-1.9x10(3)), but without statistical significance. The mean severity of posterior capsular opacification in PEG-IOL was much lower than in the control, especially at week 3. Scanning electron microscopy revealed more patch-like cells firmly attached to the lens surface in the control. CONCLUSIONS: PEG polymerization of the acrylic IOL may lessen the formation of posterior capsular opacification.