Tackling PCO once and for all

PCO secondary cataract, no matter how you label it, it exists and it is the most common complication of cataract removal or extraction.

Posterior capsule opacification/PCO/secondary cataract, no matter how you label it, it exists and it is the most common complication of cataract removal or extraction. In essence, PCO occurs when the eye attempts to make a new lens from any remaining lens material, thus leading to a decline in visual function. Many studies have been conducted to elucidate the exact causes of this complication and consequently suggestions have been made on how it can be avoided; such as altering surgical technique, refining surgical instruments and implementing new designs to IOLs. One fact that is now known, however, is PCO is caused by a number of factors, related to both IOL design and surgical technique and, as such, it makes sense to tackle PCO from a number of angles. Here, Liliana Werner, MD, PhD informs us of the precautions that should be made in order to eradicate the most common and unwanted side effect of cataract surgery.

The technique, which slightly tents up the edge of the anterior capsule using the tip of the cannula while injecting the fluid, is used by many surgeons to facilitate cortex and equatorial lens epithelial cells removal. The safety of the operation is also enhanced with this procedure. We emphasize that complete cortical removal is critical in contributing towards the prevention of PCO. Following successful cortical cleaving hydrodissection, the operation is also easier and faster.2 Experimental studies have used different solutions during the hydrodissection step of the phacoemulsification procedure, e.g., preservative-free lidocaine 1%, antimitotics, etc.3,4 However, further studies are necessary to establish the safety and utility of these solutions in PCO prevention.

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