Prevention and Treatment of Posterior Capsule Opacification Following Artificial Lens Implantation

Posterior Capsule Opacification (PCO) or Posterior subcapsular cataract (PSC) is a disease characterized by opacification and loss of transparency of the posterior capsule of the lens, which develops either primarily or secondarily after surgical treatment of primary cataract and causes decreased visual acuity and reduced contrast sensitivity. Despite significant progress in cataract surgery, secondary PCO remains a significant challenge for clinical medicine and healthcare. This paper reviews the pathogenesis of the disease and modern preventive and therapeutic strategies, focusing on the design and material of the artificial intraocular lens, as well as laser and surgical techniques and pharmacotherapy. From a preventive point of view, the association of acrylic and silicone, hydrophilic and hydrophobic lenses with the development of secondary PCO and the need for additional treatment is compared. Surgical preventive approaches aim to minimize the lens epithelial cells and their proliferation potential, which can be achieved by thorough cleaning-polishing of the cortical masses, hydrodissection or posterior capsulorhexis, the latter of which is of particular interest. Pharmacotherapeutic approaches are still only theoretical in nature. It should be emphasized that the existing data need to be clarified by additional studies. Regarding treatment, the Nd:YAG laser posterior capsulotomy method is discussed with its solution and current challenges. Since PCO remains a significant challenge in ophthalmic surgery, it is important to have an interdisciplinary approach to improve lens design and materials, as well as to thoroughly research and refine less studied preventive approaches.