Relationship of Posterior Capsular Opacification and Capsular Bend Type Investigation Based on Swept-source Optical Coherence Tomography.

Purpose: To investigate the relationship between capsular bend type and posterior capsule opacification (PCO) at a three-dimensional (3D) level using high-speed swept-source optical coherence tomography (SS-OCT).Methods: This was a retrospective study. A total of 99 eyes that underwent standard cataract surgery with phacoemulsification 2 years ago were analyzed. Standard SS-OCT radial scanning was performed in all eyes and the obtained photos were used for morphological observations of the capsular bend-IOL complex, the adhesion of posterior capsule to the IOL optic, and the position of the anterior capsulorhexis. Digital retroillumination photographs were taken of the posterior capsule of each eye to evaluate PCO (scoring and area).Results: In terms of the PCO score and area, there was no statistical difference between eyes with complete and incomplete adhesion of posterior capsule to IOL (both P > .05), whereas the partial overlap group showed a statistical difference greater than the total overlap group (P < .05). There were two types of capsular bends, completed adhesion (CA) and incomplete adhesion (IA). IA was divided into funnel adhesion (IA-F), parallel adhesion (IA-P), and detached adhesion (IA-D). The incomplete adhesion index (IAI) varied between eyes and ranged from 0 to 1. The PCO score and area in the high IAI group (higher than 0.50) were significantly greater than the low IAI group (< 0.50) (P < .05). In addition, the PCO score and area were significantly higher in the cohort with at least one IA-D capsular bend in six districts to the group that did not have IA-D capsular bend (P < .05).Conclusions: Complete or incomplete adhesion of the posterior capsule to the IOL optic may not be necessary for the development of PCO. Our study suggests that capsular bend type may be used as an index to predict PCO.

Three-Dimensional Morphology Study of Capsule in Pseudophakic Eyes with High-Speed Swept-Source Optical Coherence Tomography.

PURPOSE: To study the capsule morphology in pseudophakic eyes on the three-dimensional level using high-speed swept-source optical coherence tomography (SSOCT). METHODS: This study collected patients with age-related cataract and divided them into two groups according to the anterior capsule and intraocular lens (IOL) optic relationship: total anterior capsule overlap (360°, Group-T) and partial anterior capsule overlap (<360°, Group-P). One standard SSOCT radial scanning was performed in all eyes at 1 day, 1 week, 1 month, and 3 months postoperatively. RESULTS: Thirty-two eyes from 25 patients were enrolled in the Group-T and 17 eyes from 13 patients in the Group-P. No eyes achieved complete adhesion between IOL optic and posterior capsule at 1 day after the surgery. However, the rate of complete adhesion was low (15/49, 30.6%) even at 3 months postoperatively and there was no statistically difference between Group-T and Group-P (21.9% vs. 47.1%, P > 0.05). At 1 day, 1 week, 1 month, and 3 months after the surgery, the capsule bend index (CBI) in the Group-T was 0.02 ± 0.09, 1.35 ± 1.48, 3.60 ± 0.54, and 3.88 ± 0.19, respectively. CBI rises linearly during the first month and the rise goes stable relatively with the great reduction of standard deviation in the following 2 months (All P < 0.05). The anterior capsule opening area and diameter were both reduced in the first month, and then they both became stable. CONCLUSIONS: With square-edge IOL, posterior capsule opacification risk is still high in most eyes at 3 months postoperatively for the complete adhesion of posterior capsule and IOL was only achieved in 30.6% eyes. IOL-in-bag may be driven by the significant capsule bag changes especially in the first month postoperatively.