Cooksley Grace, Lacey Joseph, Dymond Marcus K, Sandeman Susan
School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton BN2 4GJ, UK.
The Ridley Innovation Centre, Rayner Intraocular Lenses Limited, Worthing BN14 8AG, UK.
Pharmaceutics. 2021 Jun 10;13(6):860. doi: 10.3390/pharmaceutics13060860.
Posterior capsule opacification (PCO) is the most common complication arising from the corrective surgery used to treat cataract patients. PCO arises when lens epithelial cells (LEC) residing in the capsular bag post-surgery undergo hyper-proliferation and transdifferentiation into myofibroblasts, migrating from the posterior capsule over the visual axis of the newly implanted intraocular lens (IOL). The developmental pathways underlying PCO are yet to be fully understood and the current literature is contradictory regarding the impact of the recognised risk factors of PCO. The aim of this review is firstly to collate the known biochemical pathways that lead to PCO development, providing an up-to-date chronological overview from surgery to established PCO formation. Secondly, the risk factors of PCO are evaluated, focussing on the impact of IOLs' properties. Finally, the latest experimental model designs used in PCO research are discussed to demonstrate the ongoing development of clinical PCO models, the efficacy of newly developed IOL technology, and potential therapeutic interventions. This review will contribute to current PCO literature by presenting an updated overview of the known developmental pathways of PCO, an evaluation of the impact of the risk factors underlying its development, and the latest experimental models used to investigate PCO. Furthermore, the review should provide developmental routes for research into the investigation of potential therapeutic interventions and improvements in IOL design in the aid of preventing PCO for new and existing patients.
后囊膜混浊（PCO）是白内障患者矫正手术最常见的并发症。当手术后位于囊袋内的晶状体上皮细胞（LEC）过度增殖并转分化为肌成纤维细胞时，就会发生PCO，这些细胞会从后囊膜迁移至新植入人工晶状体（IOL）视轴上方。PCO的发生发展途径尚未完全明确，目前关于PCO已知危险因素的影响，文献观点相互矛盾。本综述的目的，一是整理导致PCO发生发展的已知生化途径，提供从手术到PCO形成全过程的最新时间顺序概述；二是评估PCO的危险因素，重点关注IOL特性的影响；三是讨论PCO研究中使用的最新实验模型设计，以展示临床PCO模型的不断发展、新开发IOL技术的疗效以及潜在的治疗干预措施。本综述通过呈现PCO已知发生发展途径的最新概述、评估其发展潜在危险因素的影响以及用于研究PCO的最新实验模型，对当前PCO相关文献做出贡献。此外，本综述应为研究潜在治疗干预措施以及改进IOL设计以帮助新老患者预防PCO提供发展方向。
