Inhibition of migrating lens epithelial cells at the capsular bend created by the rectangular optic edge of a posterior chamber intraocular lens

BACKGROUND AND OBJECTIVE: To study the mechanism of the reportedly low incidence of posterior capsule opacification (PCO) in eyes treated with a posterior chamber intraocular lens (PC IOL). MATERIALS AND METHODS: Various IOL designs, including the PC IOL, were studied using scanning electron microscopy. Rabbit lens capsules were studied histopathologically 2, 3, and 4 weeks after implantation of a PC IOL in one eye and a biconvex polymethylmethacrylate (PMMA) IOL in the contralateral eye as a control. RESULTS: The optic edge of the PC IOL was sharp and rectangular, whereas that of the biconvex PMMA or silicone IOLs from various manufacturers had been smoothed and rounded by polishing. PCO was significantly reduced in the eye with a PC IOL in all rabbits. The lens capsule wrapped tightly around the optic edge of the PC IOL so that it conformed to the same shape and thereby created a distinct rectangular bend in the capsule or a rectangle between the optic edge and the posterior capsule. Migrating lens epithelial cells (LECs) were obviously inhibited at that site. CONCLUSIONS: A discontinuous capsular bend or rectangle created by the sharp, square optic edge of the PC IOL may have induced contact inhibition to migrating LECs and reduced PCO. How, whether, and to what extent this design-dependent effect is influenced by features of the IOL material needs to be clarified by comparison with results achieved with an IOL made from the same material in a different design and vice versa.