Posterior capsular opacification (PCO) — the most common late complication of cataract surgery — is caused by which cellular mechanism?
- A Residual lens epithelial cells (LECs) migrating onto and proliferating across the posterior capsule, undergoing epithelial-mesenchymal transition (EMT) to form fibrotic Elschnig pearls and Soemmering's ring ✓
- B Fibrous ingrowth from the wound incision
- C Pigment epithelium of the iris growing along the posterior capsule
- D Vitreous condensation against the posterior capsule
Explanation
PCO (posterior capsular opacification, 'after-cataract') results from residual lens epithelial cells (LECs) remaining in the capsular fornix after surgery. These equatorial LECs proliferate and migrate centrally across the posterior capsule, undergoing EMT to become fibroblast-like myofibroblasts that generate collagen, causing fibrotic PCO (Elschnig's pearls and Soemmering's ring). Prevention strategies include hydrophobic acrylic IOL materials (enhanced capsule-IOL adhesion), 360-degree square-edge IOL optic design (physical barrier), and thorough cortical cleanup. Treatment is Nd:YAG laser posterior capsulotomy.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.