Natural course of Elschnig pearl formation and disappearance.
OBJECTIVE
To observe and analyze the daily and weekly changes in morphology and size of Elschnig pearls in eyes with after-cataract.


METHODS
Pseudophakic eyes with pronounced regeneratory posterior capsule opacification (PCO) were included in this prospective study. High-resolution retroillumination images were taken, and the changes in size and shape of Elschnig pearls were analyzed at baseline and at 2, 7, and 14 days later using dedicated imaging software.


RESULTS
In total, 6309 Elschnig pearls in 85 eyes of 77 patients were analyzed. On average, four pearls were found per square millimeter (range, 0.2-9.7/mm(2); CV, 49.5%) with a mean cumulative area of 0.66 mm(2) (range, 0.03-2.18 mm(2); CV, 66.7%) of all marked pearls per eye and follow-up, which was 3.8% of the analyzed area. The mean pearl size was 9630 microm(2) (range, 2390-33,745 microm(2); CV, 61.0%) at baseline, which corresponded to a diameter of 174 microm. The mean change of a pearl per day was 583 microm(2) (range, 175-1631 microm(2); CV, 55.4%) or a 6% change in area. In total, 36% (CV, 5.5%) of all pearls increased in size, 7% (CV, 8.6%) did not change, and 35% (CV, 6.7%) decreased in size during 1 week. Furthermore, 11% (CV, 6,3%) of all pearls newly appeared, and the same number disappeared (CV, 5.7%) within 1 week.


CONCLUSIONS
Elschnig pearls disappear and appear within days. The degree of progression and regression varies greatly between eyes. Knowledge about Elschnig pearl turnover may be of importance for attempts to modulate lens epithelial regeneration or lens regrowth and for lens-refilling procedures.
Findl
Oliver
O
Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom. oliver@findl.at
Neumayer
Thomas
T
Hirnschall
Nino
N
Buehl
Wolf
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000175:diagnosis*; D002465:Cell Movement; D049109:Cell Proliferation; D004847:Epithelial Cells / Q000473:pathology*; D006801:Humans; D053685:Laser Therapy; D007903:Lens Capsule, Crystalline / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D010781:Photography; D011183:Postoperative Complications; D011446:Prospective Studies; D019591:Pseudophakia / Q000150:complications; D013997:Time Factors