Journal of Clinical and Experimental Ophthalmology
Open Access

Abstract

Liquefaction in the Prevention of Posterior Capsule Opacification–Safety and Efficacy

Nada Jiraskova, Marie Kalfertova, Marya Burova, Jana Nekolova, and Pavel Rozsival

Purpose: To evaluate the extent of posterior capsule opacification (PCO) following cataract surgery – torsional phacoemulsification with liquefaction method removal of the epithelial cells (right eye), and straight forward torsional phacoemulsification (left eye), with subsequent implantation of the AcrySof SA60AT intraocular lens.
Methods: In this prospective clinical trial patients with bilateral cataract were observed. The Evaluation of Posterior Capsule Opacification (EPCO) 2000 software and the Open-Access Systematic Capsule Assessment (OSCA) system were used for PCO assessment at 3, 6, 12 and 24 months after surgery. Postoperative changes in endothelial cell count (ECC) and pachymetry were also evaluated.
Results: The mean value for total EPCO index at 3, 6, 12 and 24 months postoperatively was respectively for the right eye 0.289 ± 0.223, 0.276 ± 0.176, 0.309 ± 0.185 and 0.418 ± 0.253, and for the left eye 0.302 ± 0.191, 0.301 ± 0.168, 0.355 ± 0.206 and 0.468 ± 0.309. The mean value for OSCA score (New Analysis) was for the right eye 0.612 ± 0.279, 0.603 ± 0.339, 0.559 ± 0.265 and 0.642 ± 0.401, and for the left eye 0.630 ± 0.398, 0.629 ± 0.366, 0.535 ± 0.331 and 0.574 ± 0.340. One patient underwent Nd-YAG laser capsulotomy one year after surgery (both eyes), and one patient two years postoperatively (right eye). There was minimal reduction in endothelial cell count and minimal changes in corneal thickness in both eyes.
Conclusions: The AquaLase method is safe for ocular tissue. Two years after surgery, most cases of PCO were graded as minimal by both systems of analysis. Not withstanding the slightly better results in eyes with AquaLase polishing of the posterior capsule, this technique was not able to completely prevent a natural progression of PCO.