Low-intensity ultraviolet A irradiation of the lens capsule to remove lens epithelial cells during cataract surgery. Effectiveness and safety.
OBJECTIVE
To assess the effectiveness and safety of low-intensity ultraviolet A (UVA) irradiation in removing lens epithelial cells (LECs) during cataract surgery and compare them with those of mechanical polishing and no treatment.


METHODS
Eyecove Ophthalmology Clinics, Pune, India.


METHODS
This prospective randomized double-masked study consisted of preoperative screening of 36 patients, of which 30 met the inclusion criteria and were recruited. The patients had routine cataract surgery. A bean-shaped capsulorhexis was performed. After the nucleus and cortex were removed, the capsular bag was irradiated from inside with low-intensity UVA in 1 group. A second group had mechanical polishing, and a third group was not treated. A small flap of the anterior capsule was removed in each patient. The flap was stained and mounted in a Fuchs-Rosenthal chamber. For estimation of effectiveness, the area of capsule covered with epithelial cells was estimated by examination under a light microscope. One day postoperatively, an examination was performed to assess the safety of each technique.


RESULTS
The area of the capsule from which the LECs were removed was significantly larger in the UVA-irradiation group than in the mechanical-polishing group (P = .001) and the no-treatment group (P = .001). There was no significant difference between the mechanical-polishing and no-treatment groups (P>.05). The area of the capsule flap that was covered with LECs was significantly less in the UVA-irradiation group than in the mechanical-polishing group (P = .017) and the no-treatment group (P = .001). The mechanical-polishing group and no-treatment group were not significantly different from each other (P>.05). Corneal edema was significantly less in the UVA-irradiation group than in the mechanical-polishing group (P<.001) and no-treatment group (P = .012). No patient in the UVA-irradiation group had postoperative lid edema; 8 patients in each of the other 2 groups had lid edema. The difference was statistically significant (P<.0001). Pupil size was significantly larger in the UVA-irradiation group than in the mechanical-polishing group and no-treatment group; the difference was significant (both P = .0001). There was no significant difference in pupil size in the mechanical-polishing group and no-treatment group. No significant difference was observed between the 3 groups in visual acuity, conjunctival edema, anterior chamber flare, and intraocular pressure.


CONCLUSIONS
Ultraviolet A irradiation of the capsular bag was effective and safe in removing LECs from the anterior capsule during cataract surgery.
Raut
Rajeev M
RM
Eyecove Ophthalmology Clinics, Pune, Maharashtra, India.
D000368:Aged; D017209:Apoptosis / Q000528:radiation effects; D019923:Capsulorhexis; D002387:Cataract Extraction / Q000379:methods*; D002452:Cell Count; D015715:Corneal Edema / Q000517:prevention & control; D004311:Double-Blind Method; D004847:Epithelial Cells / Q000473:pathology / Q000528:radiation effects*; D005260:Female; D005355:Fibrosis / Q000517:prevention & control; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000473:pathology / Q000528:radiation effects*; D019654:Lens Implantation, Intraocular; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome; D014466:Ultraviolet Rays