Posterior capsule opacification (PCO) following cataract surgery is primarily caused by which cell type and process?
- A Corneal endothelial migration onto the posterior capsule
- B Vitreous syneresis causing adhesion to the posterior capsule
- C Residual lens epithelial cells (LECs) migrating to the posterior capsule and undergoing fibrous metaplasia or Elschnig pearls (Soemmering ring formation) ✓
- D Inflammatory macrophages from postoperative iritis depositing fibrin
Correct answer: C. Residual lens epithelial cells (LECs) migrating to the posterior capsule and undergoing fibrous metaplasia or Elschnig pearls (Soemmering ring formation)
Explanation
PCO arises from residual lens epithelial cells (LECs) on the equatorial and anterior capsule that were not removed during surgery. These cells proliferate and migrate centrally across the posterior capsule, forming two patterns: fibrosis (fibrous metaplasia of anterior LECs — Soemmering ring) and pearl-type opacification (Elschnig pearls from equatorial LECs undergoing aberrant differentiation). Square-edge IOL design mechanically inhibits LEC migration across the posterior capsule, reducing PCO. Nd:YAG capsulotomy is the treatment of established PCO.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.