Abstract

SA.22.01

PCO prevention through capsule polishing with a shock wave

Wolfram Wehner
Maximilians-Augenklinik Nürnberg

Objective
Three years ago we have started to remove lens epithelial cells in the capsular bag after successful cataract surgery. To detach the cells we used the cataract surgery hand piece of the photolysis cataract surgery system by applying a shock wave.
In the beginning we only treated 180° of the inner anterior capsular bag. Since early this year we extended to a full circumference treatment.
Methods
After we recorded iris trauma in the beginning of the capsule polishing, we now have developed a method to remove the cells without causing any iris trauma. We use methocel (HPMC), which is placed between iris and capsular bag before the treatment begins. For application of the shock wave, the hand piece is inserted into the capsular bag through the phaco paracentesis and afterwards through a second smaller paracentesis opposite to the other. 360° of the anterior capsular bag are treated with the shock wave.
Results
The first capsular polishing treatments, which were done on 180° only, showed always a prevention of the opacification at the treated side, but a proliferation of cells in the follow up time from the untreated side. In patients generating PCO, it extended gradually over the complete posterior part of the bag. The capsule polishings done from beginning of this year over 360° show a general PCO prevention.
Conclusions
The application of the shock waves seems to effectively prevent PCO. Now we have to look if the 360° treatment also shows a preventive effect in the long term follow up.

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