RGDRGD肽对人晶状体上皮细胞黏附与增生作用的影响

背景RGD肽是一类含有精氨酸-甘氨酸-天冬氨酸的小分子多肽,其在抑制肿瘤细胞黏附、转移和肿瘤新生血管的生成中起重要作用。研究证实RGD肽能够抑制晶状体上皮细胞（LECs）的黏附和增生,RGDRGD肽串联起来作用增强。目的研究RGDRGD肽对体外培养的人LECs黏附与增生的影响,并与RGD肽的作用进行比较。方法将在体外分离培养的LECs中分别加入250、500、1000mg／L的RGDRGD肽和RGD肽作为实验组,仅加入细胞培养液作为对照组。将LECs以2×10。／ml密度接种到含有纤维连接蛋白（FN）和I型胶原蛋白预孵化的96孔培养板中,培养1h后用MTT比色法检测RGDRGD肽与RGD肽对细胞黏附率的影响。将LECs接种于培养板,分别加入250、500、1000、2000mg／L的RGDRGD肽和RGD肽培养24、48、72h,检测RGDRGD肽和RGD肽对LECs增生的影响。结果RGDRGD肽对人LECs黏附率的抑制呈明显的剂量依赖性,随着其质量浓度的增加,对细胞黏附的抑制作用越强,500mg／L的RGDRGD肽比RGD肽抑制人LECs黏附的作用更强（P〈0．01）。RGDRGD肽对人LECs增生的抑制呈明显的时间剂量依赖性,1000mg／L的RGDRGD肽作用48h比RGD肽对人LECs增生的抑制作用更强（P〈0．01）。结论RGDRGD肽抑制LECs黏附与增生的作用强于RGD肽,为进一步临床应用提供了理论依据。     

In vitro bovine and human lens epithelial cell culture studies on inhibition of posterior capsule opacification using a cyclic RGD peptide

BACKGROUND: RGD peptides competitively inihibit adhesion molecules of the lens epithelial cells (LEC). The purpose of our study was to investigate whether this peptide is capable of detaching adherent cells and preventing posterior capsule opacification (PCO). METHODS: Cultures of bovine and human LECs on culture dishes and discs of bovine anterior lens capsules were used. The inhibition of adhesion and the detachment of confluent LEC layers by the cyclic RGD peptide cRGDdFV were studied (incubation time was 3 days and 1 h and concentrations of 10(-4) and 10(-3) M were used). RESULTS: A dose-dependent inhibition of adhesion (48% and 42%, respectively) was obtained. There was a significant difference between the control peptide group and cRGDdFV (p < 0.0001). Cell detachment from lens capsules was not achieved but complete detachment from the culture dish occurred after 37 min. CONCLUSIONS: Short-term incubation of LECs by cRGDdFV did not lead to a sufficient inhibition of adhesion in vitro. A detachment of adherent LECs by cRGDdFV was not achieved.     

Efficacy of various drugs in the prevention of posterior capsule opacification: experimental study of rabbit eyes

PURPOSE: To assess the efficacy of various drugs in the prevention of posterior capsule opacification (PCO) in a closed capsular bag technique. SETTING: Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida, USA. METHODS: Lens material was removed using phacoaspiration or phacoemulsification through a microcapsulorhexis according to the hardness of the crystalline lens correlated with the weight and age of the rabbits. A mixture of an ophthalmic viscosurgical device (sodium hyaluronate 1.4% [SHA]) and a drug was injected into the empty capsular bag, allowed to remain inside for 3 minutes, and removed. The capsular bag was rinsed with balanced salt solution (BSS) and refilled with SHA. In a group of rabbits, the capsulorhexis was sealed with a minicapsulorhexis valve (MCV). Rabbits were treated with 1 of the following: SHA (control), BSS, mitomycin-C (MMC, 0.2 mg/mL), ethylenediaminetetraacetic acid (EDTA) (10 mM and 15 mM), 5-fluorouracil (5-FU, 33 mg/mL), acetic acid (3%, 0.3%, and 0.003%), and distilled water. RESULTS: Upon completion of the study, the control and treated eyes had PCO and new lens material (not residual). Anterior capsule proliferation was observed in eyes treated with 5-FU. The order of PCO appearance (earliest to latest) was as follows: 15 mM EDTA, SHA, MMC, acetic acid 0.3%, acetic acid 3%, BSS, distilled water (small animals; no MCV), acetic acid 0.003%, 5-FU, 10 mM EDTA, and distilled water (large animals; MCV). The earliest appearance was day 1 postoperatively and the latest, day 47. CONCLUSIONS: Distilled water and 10 mM EDTA treatments were the most efficient in retarding the appearance of PCO.     

Posterior capsule opacificationPart 1: Experimental investigations

Posterior capsule opacification (PCO) is the most frequent complication associatedwith decreased vision after cataract surgery. Previous methods of preventing PCO have not proven to be practical, effective, and safe for routine clinical procedure, but some novel concepts and methods have recently been developed. This 2-part review looks at clinical and experimental investigations of PCO, focusing on developments since 1992. Clinical aspects will be presented in a later issue. This paper addresses (1) in vitro models for PCO research; (2) pathophysiology and molecular biology of lens epithelial cells (LECs); (3) prevention of PCO. Of special interest are methods of culturing human LECs obtained by capsulotomy during cataract surgery, including those obtained with an intact capsular bag, to provide an in vitro model for investigating the pathophysiology of LECs; the effect of a sharp bend in the lens capsule that induces contact inhibition of migrating LECs; more specific inhibition of migrating LECs using an immunotoxin, b-FGF-saporin, or EDTA and RGD-peptides.     

EDTA与多聚赖氨酸的铰链物抑制兔后发性白内障的实验研究

目的：探讨EDTA与多聚赖氨酸的铰链物对兔后发性白内障的防治作用。方法：将20只新西兰白兔40眼随机分为A,B,C,D共4组,4组均行透明晶状体囊外摘除术。A组为对照组,术中灌注液为BSS;B,C,D组为治疗组,术中灌注液分别为浓度为10mg/L的EDTA、多聚赖氨酸、EDTA与多聚赖氨酸的铰链物的BSS溶液。2mo后行晶状体后囊膜切片,HE染色统计晶状体上皮细胞（LECs）的密度;并行免疫组织化学染色,用医学图象分析系统检测PCNA表达平均光密度（灰度值OD）。结果：经HE染色,后囊膜LECs密度B和D组较A和C组少,且D组的LECs密度小于B组,均有显著性差异（P〈0.01）;A和C组的LECs密度相差不大,无统计学差异（P〉0.05）。免疫组织化学进行平均光密度测定,A和C组PCNA表达强阳性,B组呈部分阳性表达,D组阳性表达较B组更少。B和D组与A组、B组与D组均有显著性意义（P〈0.01）。A组和C组无显著差异性（P〉0.05）。结论：在活体兔眼中,EDTA、多聚赖氨酸与EDTA的铰链物均有抑制兔LECs增殖的作用,且EDTA与多聚赖氨酸的铰链物组对LECs的抑制作用优于EDTA组,多聚赖氨酸组对LECs的抑制作用不明显。     

Prevention of posterior capsule opacification by retinoic acid and mitomycin

BACKGROUND: Our aim was to evaluate the effect of an intraoperative single dose of retinoic acid (RA) or mitomycin C (MMC) in preventing posterior capsule opacification (PCO). METHODS: Twenty-seven rabbits were divided randomly into three groups. RA (250 microg/ml) and MMC (0.04 mg/ml) were given 0.1 ml by hydrosection and 0.9 ml into the capsular bag after phacoemulsification. The third group served as a control group. Three months after intervention PCO was graded clinically. Furthermore, proliferation of lens epithelial cells was evaluated histologically. RESULTS: Two eyes developed corneal edema in the MMC group. On clinical assessment, RA and MMC were significantly effective in preventing PCO compared with controls (P<0.005). On histological analysis, there was significantly reduced proliferative activity on posterior capsules in the treatment groups, in contrast to multilayer cells in the control group. CONCLUSION: Intraoperative single-dose administration of RA and MMC significantly prevented the development of PCO in rabbit eyes. The optimal biocompatible dosage must be carefully determined by further investigation.     

Inhibitory effects of Arg-Gly-Asp (RGD) peptide on cell attachment and migration in a human lens epithelial cell line

Posterior capsule opacification (PCO) after cataract surgery is caused by growth of residual human lens epithelial (HLE) cells on the posterior capsule. We have shown that extracellular matrix (ECM) is an essential factor for HLE cell attachment and migration. The purpose of this study was to examine the inhibitory effects of Arg-Gly-Asp (RGD) peptide on cell attachment and migration in an HLE cell line. HLE cell line cells (SRA 01/04) that were obtained by transfection of large T antigen of SV40 were cultured in the absence of serum. The culture dishes were coated with type IV collagen, laminin or fibronectin, and Gly-Arg-Gly-Asp-Ser-Pro (GRGDSP) RGD peptide (0.1, 0.3, 1.0, 2.0 mg/ml) was added to the medium. The number of attached cells was counted after 90 min of incubation, and the inhibitory effects of GRGDSP RGD peptide on cell attachment were calculated. Cell attachment on the fibronectin-coated dishes was inhibited by GRGDSP RGD peptide at concentrations higher than 0.3 mg/ml; the inhibitory rate was 80% at a concentration of 2.0 mg/ml. The inhibition of cell attachment by GRGDSP RGD peptide on laminin-coated dishes appeared only at a concentration of 2.0 mg/ml, whereas no effects were observed on the type IV collagen-coated dishes. The inhibitory effects of GRGDSP RGD peptide on cell migration were measured in medium containing 2.0 mg/ml of GRGDSP RGD peptide after 1, 3, 5 and 7 days of culture. Cell migration was inhibited by GRGDSP RGD peptide from 1 day of culture on the fibronectin-coated dishes and from 5 days of culture on the laminin-coated dishes, whereas no effects were observed on the type IV collagen-coated dishes. GRGDSP RGD peptide inhibited cell attachment and migration on laminin and fibronectin that have RGD sequences. These data suggested that RGD peptide may have the potential to prevent PCO.     

Adenovirus-mediated gene transfer to human lens epithelial cells in organ culture

PURPOSE: To assess the feasibility of using recombinant adenovirus vectors to transduce the human lens epithelial cells (LECs) involved in posterior capsule opacification (PCO). SETTING: Department of Ophthalmology and Molecular Medicine Unit, University of Manchester, Manchester, United Kingdom. METHODS: Seventeen human lens capsules were maintained in organ culture to allow LECs to proliferate onto the posterior capsule. Partly covered and completely covered capsules were infected with a recombinant adenovirus vector RAd35, encoding for the marker gene beta-galactosidase at plaque-forming units per milliliter (pfu/mL) ranging from 10(7) to 10(10) for up to 48 hours. Assessment of infection and transduction of the marker gene were achieved by calculating the percentage of cells exhibiting X-gal staining both macroscopically and microscopically. RESULTS: Staining appeared to be dependent on virus dose, with most intense staining at doses of 10(8) and 10(9) pfu/mL with decreased staining at higher and lower viral doses. Microscopic assessment demonstrated that all cells expressed beta-galactosidase when infected with 10(9) pfu, 84% at 10(8) pfu, and 45% at 10(7) pfu. At 10(10) pfu, some cytotoxicity was observed. CONCLUSIONS: These results indicate that recombinant adenoviruses can be used to transfer genes to the LECs involved in PCO. The transfer of cytotoxic genes after cataract surgery may be considered a preventive measure for PCO.     

Effect of mitomycin-C on posterior capsule opacification in rabbit eyes

PURPOSE: To determine whether mitomycin-C can inhibit posterior capsule opacification (PCO) without causing ocular toxicity. SETTING: Yonsei Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. METHODS: Mitomycin-C dissolved in sodium hyaluronate (0.2 cc of 0.2 mg/mL) was injected into the empty capsular bag for 3 minutes after endocapsular phacoemulsification in rabbit eyes. Three months after surgery, the obstruction rate of visible light caused by PCO was measured using an optical power meter. RESULTS: The mean obstruction rate of visible light was 81.0% +/- 8.3% (SD) in the control group in which sodium hyaluronate without mitomycin-C was used, 30.5% +/- 10.1% in the group in which mitomycin-C was dissolved in sodium hyaluronate, and 71.9% +/- 6.8% in the group in which mitomycin-C was dissolved in a balanced salt solution. Statistically significant differences were found among all 3 groups. CONCLUSIONS: Our results suggest that the application of mitomycin-C dissolved in sodium hyaluronate effectively reduces PCO in rabbit eyes.     

Use of a polylysine-saporin conjugate to prevent posterior capsule opacification.

PURPOSE: To determine the feasibility of applying a polylysine-saporin (PLS) conjugate to the lens capsule at surgery to prevent lens epithelial cell (LEC) proliferation and posterior capsule opacification (PCO). SETTING: Department of Research & Development, Bausch & Lomb Surgical, and Department of Ophthalmology, Saint Louis University, St. Louis, Missouri, USA. METHODS: Fluorescein-labeled polylysine was applied to the lens capsule of rabbits after phacoemulsification and analyzed histologically to determine the extent of binding to the lens capsule and surrounding tissues. The cytotoxin saporin was conjugated to polylysine using bifunctional cross-linkers. This PLS conjugate was applied to LECs in culture and to the lens capsules of rabbits. These eyes were monitored for PCO. RESULTS: Polylysine primarily bound to the lens capsule membranes, with little or no binding to surrounding tissues. When PLS was added to LECs in culture, it was internalized and destroyed the cells. Of 9 rabbit eyes treated with PLS during surgery, 1 remained free of PCO for the life of the animal (40 weeks), while 6 showed a delay of cortical regrowth approximately 2 to 3 times that of control eyes. CONCLUSIONS: Polylysine bound selectively to the lens capsule membrane. The PLS conjugation resulted in a toxic agent that targeted the lens capsule and destroyed proliferating LECs. The application of a PLS conjugate during surgery may prevent PCO.     

多聚赖氨酸与EDTA的交联物防治兔眼后囊膜混浊的研究

目的 观察在白内障术中应用多聚赖氨酸与EDTA的交联物对晶状体后囊膜混浊(PCO)的影响.方法 利用EDC将EDTA与多聚赖氨酸结合,制成交联物PLE.日本大耳白兔9只(18眼),随机分为3组.实验组在白内障囊外摘出术中分别于囊袋内注入药物:EDTA组注入EDTA 20 mmol/L;PLE组注入PLE其中含EDTA 10 mmol/L、NH2-10 mmol/L;对照组囊袋内不注入药物.术后用裂隙灯观察眼内组织的变化.28 d后处死兔子,摘除眼球,制作病理切片,光镜下观察晶状体上皮细胞(LECs)增生情况.结果 PLE组仅有少量细胞残留,未见细胞增生,其他组均可见不同程度的细胞残留及增生.结论 与EDTA相比,PLE可更有效地清除LECs.     

Mitomycin C in higher risk trabeculectomy: a prospective comparison of 0.2- to 0.4-mg/cc doses.

PURPOSE: This randomized, masked, prospective study was conducted to compare the outcome of filtering surgery using doses of 0.2 mg/cc or 0.4 mg/cc of mitomycin C (MMC) in eyes that were at higher risk from previous conjunctival incisional surgery. METHODS: Eyes of 50 consecutive patients with primary open-angle, pseudoexfoliation, or pigmentary glaucoma requiring trabeculectomy who had previously undergone either limbal cataract surgery or trabeculectomy were enrolled. Patients received an intraoperative dose of either 0.2 or 0.4 mg/cc MMC for 2 minutes (n = 25 in each study group). Intraocular pressure (IOP), logMAR visual acuity, and complications were monitored at regular intervals for 1 year. Unpaired student t tests were used to compare percent decrease in IOP in both study groups at each interval. RESULTS: The percent decrease in IOP was not significantly different between groups at 1 day, 1 week, 1 month, 3 months, 6 months, or 1 year after surgery. LogMAR visual acuity was not significantly different between groups at 1 month, 6 months, or 1 year. Treatment failure occurred in seven patients in the 0.2 mg/cc group (28%) and seven patients in the 0.4 mg/cc group (29.2%). Postoperative hypotony, choroidal effusions and hemorrhages, and wound leaks occurred in both groups, but occurred more often in the group receiving 0.4 mg/cc MMC. CONCLUSION: Filtering surgery performed on higher risk eyes was as effective using a lower dose (0.2 mg/cc) of MMC as that using a higher dose (0.4 mg/cc). Incidence of complications and treatment failures was slightly higher in the group receiving high-dose MMC.     

Effect of tranilast eyedrops in preventing posterior capsule opacification: preliminary report.

PURPOSE: To evaluate the effect of tranilast eyedrops in preventing fibrous opacification of the posterior lens capsule after cataract extraction and intraocular lens (IOL) implantation. SETTING: The Second Department of Ophthalmology, Toho University School of Medicine, Tokyo, and Shohzankai Medical Foundation, Miyake Eye Hospital, Nagoya, Japan. METHODS: This study comprised eyes having continuous curvilinear capsulorhexis and phacoemulsification/aspiration followed by implantation of a posterior chamber IOL in the capsular bag. In this prospective, randomized, controlled, and double-masked trial, tranilast 0.5% (Rizaben) eyedrops (15 eyes) or its placebo eyedrops (20 eyes) were given 4 times a day for 3 months after surgery. An anterior eye segment analysis system (EAS 1000, Nidek Co., Ltd.) was used to evaluate the degree of fibrous posterior capsule opacification (PCO) 1 week and 1 and 3 months after surgery. RESULTS: The mean PCO density in the tranilast group was 17.1 cct +/- 4.6 (SD), 20.0 +/- 3.6 cct, and 23.0 +/- 7.7 cct (cct = computer compatible tape) at 1 week and 1 and 3 months, respectively. In the control group, it was 18.2 +/- 5.3, 30.2 +/- 7.8, and 38.4 +/- 8.0 cct, respectively. There was a significant difference in the 1 and 3 month findings between the 2 groups (P < .001). CONCLUSION: Tranilast was effective in preventing fibrous PCO at an early postoperative stage. The possible mechanisms of its effect may be prevention of collagen synthesis by minimizing transforming growth factor type beta released during lens epithelial cell metaplasia.     

核心蛋白多糖对兔晶状体上皮细胞增生的抑制作用

背景 研究发现,白内障囊外摘出术后组织修复反应可诱导房水中活性转化生长因子β(TGF-β)的增加,残留的晶状体上皮细胞(LECs)移行、分化,细胞外基质沉积,引起上皮-间质转化,导致后囊膜混浊(PCO)的发生.寻求有效的抑制LECs增生的药物对于临床上防治PCO的发生具有重要意义. 目的 探讨核心蛋白多糖( decorin)对兔LECs增生的抑制作用及其剂量-效应与时间-效应的关系. 方法 兔LECs细胞株进行培养和传代,将处于指数生长期的细胞以8×106个/L密度接种于96孔板,将0.1、1.0、10.0 mg/Ldecorin分别加入培养基中培养24、48、72 h,加入体积分数0.1％ DMSO培养的细胞为阳性对照组,常规培养基培养的细胞为空白对照组.MTT比色法分别测定不同质量浓度的decorin作用于LECs不同时间后的细胞生长抑制率;采用流式细胞技术测定各组细胞的细胞周期,用ELISA法检测各组培养液上清中TGF-β的水平,逆转录聚合酶链反应(RT-PCR)法测定TGF-βmRNA在LECs中的表达,免疫细胞化学法观察α-平滑肌肌动蛋白(α-SMA)的表达.结果 ELISA检测结果表明,各组培养基上清液中TGF-β表达量的差异有统计学意义(F=39.24,P=0.03),不同质量浓度组TGF-β水平均明显低于空白对照组,差异有统计学意义(P＜0.01),1.0 mg/L、10.0 mg/L decorin组TGF-β水平均明显低于0.1 mg/L decorin组(P＜0.05).MTT比色法结果显示,≥1.0 mg/L decorin组LECs增生的抑制率明显高于空白对照组,各质量浓度decorin组药物作用48 h和72 h后LECs增生的抑制率明显高于24 h的值,药物作用72 h后LECs增生的抑制率明显高于48 h的值,差异均有统计学意义(P＜0.05),各质量浓度decorin组G0/G1期LECs所占比例均较空白对照组明显增加,差异均有统计学意义(P＜0.05).RT-PCR检测显示,TGF-β mRNA的表达随着decorin质量浓度的升高而降低.免疫组织化学染色表明,10.0 mg/L decorin组α-SMA在LECs中的表达明显弱于空白对照组. 结论 Decorin可以抑制LECs的增生,也可以诱导LECs凋亡,其效应呈明显的剂量和时间依赖性,有望成为最具潜力的防治PCO的药物之一.     

Effect of surface coating an acrylic intraocular lens with poly(2-methacryloyloxyethyl phosphorylcholine) polymer on lens epithelial cell line behavior

PURPOSE: To evaluate the effect of surface coating of an acrylic intraocular lens (IOL) with poly(2-methacryloyloxyethyl phosphorylcholine) (MPC) on the behavior of the lens epithelial cell (LEC) line, alpha-TN4. SETTING: Department of Ophthalmology, Nihon University School of Medicine, Tokyo, Japan. METHODS: A hydrophobic soft acrylic IOL (AF-1, Hoya) was coated with MPC polymer. A noncoated IOL served as control. An IOL from each group was placed on the membrane of collagen I or IV of the cell culture dish. The alpha-TN4 cells were seeded in the insert. Cell behaviors (ie, cell proliferation and spreading) on IOLs and membranes were observed. Cell migration beneath the IOL optic portion was assayed using a computer software program (POCOman system) for posterior capsule opacification (PCO). Type I or IV collagen is the major matrix component of PCO or native lens capsule. RESULTS: Cell proliferation was more marked on the noncoated IOL than on the coated IOL. Type IV collagen accelerated proliferation more than type I collagen. Cell migration to the area beneath the IOL optic was more prominent in the group with the type I collagen membrane and noncoated IOL than in other groups. CONCLUSION: Coating an acrylic IOL surface with MPC polymer suppressed adhesion and proliferation of LECs, suggesting it improves IOL biocompatibility.     

Relationship between anterior capsule contraction and posterior capsule opacification after cataract surgery in patients with diabetes mellitus

PURPOSE: To prospectively assess the relationship between contraction of the anterior capsule opening and posterior capsule opacification (PCO) after cataract surgery in patients with diabetes mellitus. SETTING: Department of Ophthalmology, University of Tokyo School of Medicine, Tokyo, Kaiya Eye Clinic, Hamamatsu, and Department of Ophthalmology, Institute of Clinical Medicine, University of Tsukuba, Ibaragi, Japan. METHODS: This study comprised 45 patients (45 eyes) with diabetes mellitus who had cataract surgery. In all eyes, the anterior capsule opening area and degree of PCO were determined by diaphanoscopy using an anterior eye segment analysis system (EAS-100, Nidek, Inc.) 1 day and 1 year postoperatively. RESULTS: There was no correlation between the size of the anterior capsule opening area 1 day after surgery and the degree of PCO 1 year after surgery (Pearson correlation coefficient [r] = 0.041; P =.79). The percentage reduction in the anterior capsule opening area from 1 day to 1 year after surgery did not correlate with the degree of PCO 1 year after surgery (r = -0.08; P =.60). CONCLUSION: Contraction of the anterior capsule opening and PCO after cataract surgery cannot be explained by a common mechanism.     

Active oxygen processing for acrylic intraocular lenses to prevent posterior capsule opacification

PURPOSE: To evaluate active oxygen processing on the surface of acrylic intraocular lenses (IOLs) to prevent secondary posterior capsule opacification (PCO). SETTING: Department of Ophthalmology, Dokkyo Medical University School of Medicine, Mibu City, Tochigi, Japan. METHODS: Acrylic IOLs were prepared, and ultraviolet (UV)/ozone (UV/O3) or argon plasma was irradiated to the surface of the IOLs. Elemental analysis (electron spectroscopy for chemical analysis [ESCA]) of the IOL surfaces was performed to confirm surface modification. Changes produced by UV/O3 or argon plasma treatment were examined for fibronectin and lens epithelial cell (LEC) adhesion. To evaluate the PCO prevention by treated IOLs, 8-week-old albino rabbits were used. The rabbit eyes randomly had phacoemulcification and implantation of 3 different IOLs: the UV/O3-treated IOLs, argon plasma-treated IOLs, and the control IOLs. After 2 weeks, the rabbits were killed and their globes were dissected and fixed using formaldehyde 10%. The PCO was observed using light microscopy (DX51, ORIMPUS) after hematoxylin and eosin staining. RESULTS: Comparison of IOL surface composition by ESCA showed an increase in nitrogen content and hydroxyl substitute and carboxyl substitute groups on surfaces of treated IOLs. The fibronectin adhesion and the LEC adhesion on the UV/O3-treated and argon plasma-treated samples were increased. In the untreated group, there was statistically significant inhibition of PCO formation in the UV/O3-treated and argon plasma-treated groups. CONCLUSION: Active oxygen processing and argon plasma irradiation on the surface of IOLs was effective in preventing secondary PCO after cataract surgery.     

Comparison of posterior capsule opacification in rabbits receiving either mitomycin-C or distilled water for sealed-capsule irrigation during cataract surgery

PURPOSE: To compare posterior capsule opacification (PCO) in rabbits who undergo cataract surgery and receive either mitomycin-C (MMC) or distilled water (DW) during sealed-capsule irrigation (SCI). In addition, we examined the toxicity of DW and MMC. METHODS: Twenty-four eyes from 12 rabbits were divided into three groups. Balanced salt solution (BSS), DW, MMC 0.4 mg/mL was injected into the capsular bag for 2 min after endocapsular phacoemulsification and insertion of a SCI device. The degree of PCO was assessed by POCOman software at 3 months post surgery. Central corneal thickness, anterior chamber inflammation were assessed 1 day, 1 week, 2 weeks, 3 weeks, 1 month and 3 months postoperatively. RESULTS: A statistically significant difference in PCO scores was noted between the control and study groups (P < 0.05). The PCO scores of the MMC group were significantly lower than those of the DW group (P < 0.05). The MMC and DW groups did not show significant toxicity compared with the BSS group. CONCLUSIONS: MMC is more effective in reducing PCO than DW; the SCI device can protect the surrounding ocular tissue from MMC toxicity in rabbit eyes.     

Effect of diclofenac on prevention of posterior capsule opacification in human eyes

BACKGROUND: Diclofenac sodium has been demonstrated to be effective in preventing proliferation of lens epithelial cells both in vitro and in animal studies. The effects of diclofenac sodium given during the hydrodissection stage of phacoemulsification surgery on posterior capsule opacification (PCO) were investigated. METHODS: Eleven patients undergoing phacoemulsification in both eyes were included. Patients with pseudoexfoliation, uveitis, and diabetes were excluded. Hydrodissection was done with only balanced salt solution in the first eyes. In the fellow eyes, 0.25 mg/mL diclofenac was given with hydrodissection. The same type of intraocular lens was implanted in both eyes of each patient. Follow-up was 21.8 (SD 3.5) months in the diclofenac group and 22.9 (3.7) months in the control group. PCO was evaluated clinically by dividing the posterior capsule into 24 zones. Mann-Whitney U test was used for statistical analysis. RESULTS: There were no statistically significant differences of age, diameter of capsulorhexis, pupillary width, visual acuity, intraocular pressure, or length of follow-up between groups. PCO score was 0.49 (SD 0.21) in eyes receiving diclofenac and 0.73 (0.23) in the contralateral fellow eyes. The difference was not statistically significant (p=0.053). INTERPRETATION: Diclofenac sodium given by hydrodissection in phacoemulsification decreased, but did not significantly prevent, the development of PCO.     

Posterior capsule opacification after phacoemulsification in patients with postoperative steroidal and nonsteroidal treatment

PURPOSE: To evaluate the effect of dexamethasone, diclofenac, and a placebo given for 3 weeks after phacoemulsification and intraocular lens (IOL) implantation on the formation of posterior capsule opacification (PCO). SETTING: St. Erik's Eye Hospital, Stockholm, Sweden. METHODS: In a 2-year prospective randomized double-blind study, a laser flare meter was used to measure aqueous flare intensity preoperatively and 3 days, 2 weeks, and 2 years after phacoemulsification and IOL implantation. Posterior capsule opacification was evaluated 2 years postoperatively using retroillumination images taken with a Scheimpflug camera. The Evaluation of Posterior Capsule Opacification system was used to score the areas of PCO density. RESULTS: The median rate of PCO 2 years after phacoemulsification was 0.72 (range 0.32 to 1.57) in the dexamethasone group, 0.78 (range 0.19 to 2.14) in the diclofenac group, and 0.70 (range 0.35 to 1.70) in the placebo group. The differences were not statistically significant (P>.05; Kruskal-Wallis analysis of variance, multiple comparisons). The rate of neodymium:YAG laser posterior capsulotomy during the 2 years after surgery was not statistically different between groups (P>.05, chi-square test). There was no correlation (Spearman rank coefficient) between laser flare measurements and PCO formation in any group during the study (P>.05). CONCLUSION: Topical instillation of diclofenac, dexamethasone, or a placebo in the immediate period after phacoemulsification and IOL implantation did not seem to influence the formation of PCO 2 years after cataract surgery.