Long-term results of sealed capsule irrigation using distilled water to prevent posterior capsule opacification: a prospective clinical randomised trial.
BACKGROUND
We investigated long-term safety and efficacy of sealed capsule irrigation (SCI) during cataract surgery to prevent posterior capsule opacification (PCO).


METHODS
One eye of each of 17 patients (mean age: 70.1+/-9.7 years) who presented with bilateral cataracts was randomly chosen for SCI treatment. After phacoemulsification, the capsular bag was vacuum sealed with the PerfectCapsule device (Milvella) followed by SCI using distilled water for two minutes. No vacuum loss occurred during irrigation. Each patient's fellow eye served as a control. One hydrophilic acrylic intraocular lens model was implanted in all eyes. Five patients had to be excluded due to deep anterior chamber, small pupil or unilateral surgery. Follow-up examinations took place one day and one, three, six, 12 and 24 months after surgery. We evaluated safety parameters, anterior capsule (AC) overlapping and PCO.


RESULTS
Postoperatively, mean best corrected visual acuity, pachymetry, endothelial cell count, intraocular pressure, AC overlapping and PCO showed no statistically significant difference between SCI and the control group (p>0.05, Wilcoxon test).


CONCLUSIONS
SCI is a safe procedure and enables the specific pharmacological targeting of lens epithelial cells inside the capsular bag. Using distilled water, however, it is not possible to reduce PCO development significantly. Thus, alternative substances should be evaluated.
Rabsilber
Tanja M
TM
International Vision Correction Research Centre (IVCRC), Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Germany.
Limberger
Il-Joo
IJ
Reuland
Andreas J
AJ
Holzer
Mike P
MP
Auffarth
Gerd U
GU
D000328:Adult; D000368:Aged; D002386:Cataract / Q000209:etiology / Q000517:prevention & control*; D042783:Endothelial Cells / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure; D007430:Intraoperative Care / Q000379:methods*; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D055502:Secondary Prevention; D007507:Therapeutic Irrigation / Q000379:methods; D016896:Treatment Outcome; D014792:Visual Acuity