title: Removal of lens epithelial cells and the effect on capsulorhexis size.
abstract: OBJECTIVE
  To assess the long-term effects of lens epithelial cell (LEC) removal on capsulorhexis opening size.
  
  
  METHODS
  Dorset County Hospital, Dorchester, United Kingdom.
  
  
  METHODS
  This prospective randomized control study included 39 eyes of 38 patients. Twenty eyes were selected randomly for removal of LECs from the anterior capsule as part of routine cataract operation comprising phacoemulsification with intraocular lens (IOL) implantation. The other 19 eyes were used as controls in which the LECs were not removed. All surgeries were performed by 1 surgeon (A.T.). All patients had silicone IOL (Allergan SI-40) implantation. The capsulorhexis opening size was determined immediately after surgery and 2 weeks and 6 months after surgery. Data on treatment outcome of the cataract surgery were analyzed statistically.
  
  
  RESULTS
  Six months postoperatively, the size of the capsulorhexis had statistically significant increased in the study group that had LECs removed (mean increase 1.07 +/- 1.70 mm(2); paired Student t test P=.01), whereas the capsulorhexis size had statistically significant decreased in the control group (mean decrease -3.38 +/- 2.37 mm(2); paired Student t test, P<.0001). The difference in changes in the capsulorhexis areas between the 2 groups was also highly statistically significant (independent-sample Student t test, P<.0001).
  
  
  CONCLUSIONS
  Removal of anterior subcapsular LECs by aspiration helped maintain the size of the capsulorhexis opening and thus can help prevent capsule contraction syndrome.
authors.affiliation: Royal Eye Infirmary, Dorset County Hospital, Dorchester, United Kingdom. athanassius@btinternet.com
authors.forename: Athanassius
authors.initials: A
authors.lastname: Tadros
authors.forename: Uday K
authors.initials: UK
authors.lastname: Bhatt
authors.forename: M N
authors.initials: MN
authors.lastname: Abdul Karim
authors.forename: Asad
authors.initials: A
authors.lastname: Zaheer
authors.forename: Peter W
authors.initials: PW
authors.lastname: Thomas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019923:Capsulorhexis; D003286:Contracture / Q000517:prevention & control*; D004847:Epithelial Cells; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000166:cytology / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012826:Silicone Elastomers
chemical_list: D012826:Silicone Elastomers