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Background: The aims of this study were to determine the 5-year incidence of posterior capsule opacification (PCO) requiring Nd:YAG laser capsulotomy in a representative mixed cohort of cataract patients, to determine risk factors for PCO and to investigate possible association with growth of human lens epithelial cells (HLEC) in vitro., Methods: Pieces of the anterior lens capsule and adhering HLEC were obtained at cataract surgery and cultured individually. After one and two weeks respectively, cultured cells were stained with carboxy-fluorescein diacetate succinimidyl ester (CFDA SE), after which image processing software was used to determine the area of the confluent cell layer. The 5-year incidence of Nd:YAG laser capsulotomy in this cohort was determined through medical records and by mail or telephone interviews. For statistic analyses Mann-Whitney U-test, Fisher's exact test and binary logistic regression were used., Results: Data on treatment/no treatment for PCO was obtained from 270 patients with a median follow-up time of 57 months (range 50-64 months). The three-year cumulative incidence of PCO was 5.2% and the cumulative 5-year incidence was 11.9%. Patients who had undergone Nd:YAG laser capsulotomy were significantly younger (median 71 years) than patients who did not receive treatment for PCO (median 75 years, p = 0.022). Logistic regression demonstrated that apart from younger age, follow-up time and type of intraocular lens (IOL) were associated with risk of PCO, with hydrophilic 1-piece IOLs conferring a higher risk than hydrophobic acrylic 1-piece or 3-piece IOLs (adjusted OR = 9.4, 95% CI 2.5-35.7, p = 0.001). Of the 270 patients from whom information could be retrieved regarding PCO treatment, in vitro cell culture could be established and quantified from 185 patients. No significant difference in cell growth in vitro was shown between patients subsequently requiring/not requiring Nd:YAG laser capsulotomy., Conclusions: The cumulative 5-year incidence of 11.9% is comparable or slightly higher than reported in other recent studies. The type of IOL was the most important risk factor for PCO in this study, whereas intrinsic proliferative capacity of the individual's lens epithelial cells seems to be less important for subsequent PCO development.

Purpose: To investigate whether posterior capsule opacification (PCO) morphology, visual acuity (VA) and self-assessed visual function correlate, and to compare perceived visual disabilities with those of cataract patients with corresponding VA., Methods: Twenty-one patients with PCO were examined before capsulotomy. In adjunct to the ophthalmological examination, the patients completed a Catquest questionnaire and a digitized retroillumation image was acquired. The images were analysed with the Evaluation of Posterior Capsule Opacification (EPCO) program. Data for visual function were compared with data from the National Swedish Cataract Register (NCR)., Results: The epco values were correlated with VA in the PCO eyes: the higher the epco score, the lower the VA. There were also correlations between the epco scores, satisfaction with vision, and perceived disabilities in daily life. Symptoms of glare were not significantly correlated with epco scores or with VA. Visual acuity in PCO eyes was better correlated with perceived disabilities and satisfaction with vision than VA in eyes with cataract., Conclusions: There was a significant correlation between epco scores and VA and between epco scores and Catquest. Consequently, the morphological method was related to the self-assessed visual function. Patients with PCO seemed to have more disturbed visual function, as defined by Catquest, than cataract patients with the same VA.

Purpose: To describe the functional outcome, as defined using the Catquest questionnaire, for patients with posterior capsule opacification (PCO) after capsulotomy., Methods: A total of 47 patients with PCO were examined before and 1 month after capsulotomy. In addition to the ophthalmic examination, Catquest was completed and a digital image of the posterior lens capsule acquired., Results: Capsulotomy resulted in a good level of benefit, as defined using Catquest, for 77% of the patients. No subgroup of patients who derived an exceedingly good or poor level of benefit was identified. Disabilities in daily life, satisfaction with vision and symptoms of glare improved from treatment (p < 0.001, p < 0.001 and p = 0.002, respectively). The results were comparable with the benefits of cataract surgery., Conclusions: Self-assessed visual function as defined using Catquest improved after capsulotomy for the vast majority of patients with PCO. No group of patients with exceptionally good or poor levels of benefit could be identified with certainty. However, the majority of those with a poor outcome were elderly individuals with ocular comorbidity. The overall functional results from treatment of PCO were very similar to those achieved after cataract surgery.

Purpose: To compare posterior capsule opacification (PCO) after cataract surgery with implantation of two silicone intraocular lenses (IOLs) with different designs., Methods: We carried out a prospective, clinical study of 116 patients randomized to standardized phacoemulsification with implantation of CeeOn Edge (n = 57) or SI40NB (n = 59) IOLs. The follow-up period was 3 years. To evaluate PCO morphologically, digital images were obtained and analysed using evaluation of posterior capsule opacification computer software (epco). The neodymium:YAG (Nd:YAG) capsulotomy rate was recorded., Results: At 2 and 3 years, the eyes with SI40NB IOLs had significantly more PCO than those with the CeeOn Edge IOLs (p = 0.00014 and p = 0.002). Nine Nd:YAG capsulotomies were performed in the SI40NB group and none in the CeeOn Edge group. This difference was statistically significant (p = 0.003). In some patients a regression of PCO was noticed and confirmed using epco. Statistically less PCO was noted when the capsulorhexis rim was placed so that it covered all 360 degrees of the optic of the IOL., Conclusions: A clinically and statistically significant difference in PCO development between CeeOn Edge and SI40NB IOLs at 2 and 3 years postoperatively was found. These findings support earlier studies indicating that a sharp edge of the optic is a more important factor in IOL design than IOL material in the prevention of PCO.