Posterior capsule opacification after intraocular lens implantation

Katarakta, odnosno zamućenje leće, može se razviti kao posljedica raznih stanja kao što je starenje ili bolesti kao što je dijabetes. Zamućenje stražnje kapsule leće (sekundarna katarakta) nastaje zbog migracije i proliferacije ostatnih lećnih epitelnih stanica, nekoliko mjeseci ili godina nakon operacije katarakte u do 50% pacijenata. Rezidualne anteriorne lećne epitelne stanice migriraju s ekvatora uz stražnju kapsulu leće prema centru zjenice te se opacificiraju diferencijacijom u lećne fibre (aglomerate globularnih ili fuziformnih Elschingovih perli). Na taj način lećna kapsula postaje zamagljena. Na nastanak zamućenja stražnje kapsule utječu dizajn i materijal različitih intraokularnih leća te njihov smještaj, neke očne bolesti i stanja (retinitis pigmentosa, glaukom, pseudoeksfolijacijski sindrom, visoka miopija) te dob pacijenta. Kirurška tehnika također ima veliki utjecaj na sprječavanje nastanka zamućenja. Simptomi sekundarne katarakte slični su simptomima katarakte. Kod mnogo pacijenata, prvi znak razvoja zamućenja stražnje kapsule je slabljenje vidne oštrine te subjektivni osjećaj zamagljenja vida. Promjena vidne oštrine očituje se kao oslabljena mogućnost čitanja redova na Snellenovoj ploči za ispitivanje vidne oštrine. Neodymium:YAG laser kapsulotomija je metoda izbora u liječenju zamućenja stražnje kapsule leće. Tip lasera koji se koristi za ovaj postupak je YAG laser (yttrium aluminium garnet). Njime se načini mala rupa u kapsuli leće. Cijeli postupak traje nekoliko minuta te je u potpunosti bezbolan. Indikacija za tretman Nd:YAG laserom ovisi o gustoći zamućenja, ali i o subjektivnim tegobama koje se javljaju kod pacijenata. Upotreba farmaceutskih pripravaka za liječenje još je u ekperimentalnoj fazi.Cataract, the clouding of the lens in the eye, can develop due to multiple reasons such as aging or diseases such as diabetes. Posterior capsule opacification (PCO or secondary cataract) is caused by residual lens epithelial cells migration and proliferation, a few months or a few years after cataract removal surgery in up to 50% of treated patients. Residual anterior lens epithelial cells migrate from the equator beside posterior lens capsule towards the pupil centre and they opacificate into lens fibres by their differentiation (globular aglomerates or fusiform Elsching pearls). In that way, the capsule that holds the lens in place becomes clouded. Design and material of different types of intraocular lenses, their accommodation, some eye conditions or illnesses (retinis pigmentosa, glaucoma, pseudoexfoliation syndrome) and patient’s age affect the occurrence of PCO. Surgical technique also has a great influence in preventing the PCO. Symptoms of posterior capsule opacification or secondary cataracts are similar to those of cataracts. For many patients, the first sign of secondary cataract development is a feeling that their vision is cloudy or blurry. A change in visual acuity shown by decreased ability to read a Snellen eye chart occurs when secondary cataract develops and is significant enough to consider correction of secondary cataract with YAG laser. Treatment for secondary cataracts is the procedure called Neodymium YAG laser capsulotomy. YAG is a short for yttrium aluminium garnet, the type of laser used for the procedure. A small hole is made with a laser in the capsule. The procedure takes only a few minutes and is entirely painless. Indication for Nd:YAG laser capsulotomy not only depends on opacification density, but also depends on the patients subjective visual deterioration. Pharmaceutical substance usage for treating this condition is still in its experimental phase