Effect of femtosecond laser-assisted lens surgery on posterior capsule opacification in the human capsular bag in vitro.
OBJECTIVE
To compare posterior capsule opacification (PCO) by observing lens epithelial cell growth in the human capsular bag in vitro between conventional lens surgery using phacoemulsification (Phaco) technique and femtosecond laser-assisted lens surgery (FLACS).


METHODS
For the in vitro human capsular bag model, 18 cadaver eyes from nine human donors underwent three types of lens surgery. Three groups consisting of six capsular bags were established, that is FLACS, Phaco and extracapsular lens extraction (ECCE). The capsular bag was transferred into equal cell culture conditions after using one of the defined surgical approaches. Cellular growth of lens epithelial cells was observed and photo-documented. The time until full cell-coverage of the capsular bag was measured.


RESULTS
The human capsular bag model can be successfully prepared using FLACS. There was no statistically significant difference in time until cell-coverage of the human donor capsular bag in vitro in all three surgical settings (ECCE versus Phaco p = 0.6; ECCE versus FLACS p = 1.0; Phaco versus FLACS p = 1.0).


CONCLUSIONS
In our in vitro human capsular bag model, we could not observe a statistically significant difference in PCO formation using different surgical approaches of lens extraction. Therefore, PCO formation might not be attributed to the type of surgery. Furthermore, this study shows that FLACS can be used for the human capsular bag model preparation and validates the human capsular bag model for future research.
Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Germany.
Christian
C
Wertheimer
Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Germany.
Thomas C
TC
Kreutzer
Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Germany.
Martin
M
Dirisamer
Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Germany.
Kirsten
K
Eibl-Lindner
Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Germany.
Daniel
D
Kook
Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Germany.
Siegfried
S
Priglinger
Department of Ophthalmology, Ludwig-Maximilians-University Munich, Munich, Germany.
Wolfgang J
WJ
Mayer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D058442:Capsule Opacification / Q000473:pathology / Q000601:surgery*; D049109:Cell Proliferation; D002478:Cells, Cultured; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008875:Middle Aged; D018918:Phacoemulsification / Q000379:methods*; D057852:Posterior Capsule of the Lens / Q000473:pathology / Q000601:surgery*
cataract surgery; femtosecond laser; femtosecond laser-assisted cataract surgery; human capsular bag model; posterior capsule opacification