Purpose: To study the influence of continuous curvilinear capsulorhexis (CCC) on poly(methyl methacrylate) (PMMA) intraocular lens (IOL) biocompatibility.
Methods: Biocompatibility was assessed by measuring the postoperative blood-aqueous barrier breakdown and the cellular reaction at the anterior capsule-IOL interface. In a prospective study, 30 consecutive eyes, normal except for having extracapsular cataract extraction (ECCE) with CCC by a single surgeon, has laser flare and cell measurements and specular microscopy of the anterior IOL surface at 1 day, 1 week, and 1 and 3 months postoperatively.
Results: In addition to the foreign-body reaction previously described in eyes that had other capsulotomy types, the eyes in this study also had a lens epithelial cell (LEC) reaction. The severity of the foreign-body reaction and postoperative aqueous flare and cells was significantly less in eyes with an intact CCC than in those with rim tears in the capsulorhexis and in those having an ECCE with a linear or can-opener capsulotomy, as previously reported.
Conclusions: Continuous curvilinear capsulorhexis improves the biocompatibility of PMMA IOLs to a degree that could be of clinical benefit. In eyes with CCC, most cells seen on the anterior IOL surface were LECs.