The role of lens epithelial cells in the development of the posterior capsule opacification and in the lens regeneration after congenital cataract surgery
Abstract
Posterior capsule opacifcation–PCO is the most common complication after cataract surgery. Proliferation and migration of lens epithelial cells that remain in the capsular bag following cataract surgery can lead to the development of PCO, which is the main cause of deterioration of visual function. PCO shows the classic features of fbrosis, including hyperproliferation, migration, deposition of matrix and its shrinkage and transdifferentiation into myofbroblast. Astonishingly, the results of recent research show the importance of lens epithelium for lens regeneration following congenital cataract surgery. New minimally invasive cataract surgery removes only 1–1.5 mm of lens epithelium more laterally, so the major part of the epithelium remains in the capsular bag. Conceptually, the new method differs from the current practice, since it preserves the endogenous epithelial cells of the lens and achieves functional lens regeneration in rabbits and monkeys as well as in human infants with congenital cataracts. Pluripotency of lens epithelial cells and their stem cell nature are crucial for lens regeneration.
Ex vivo cultures of the lens capsule explants can be used for testing the pharmacological agents for stimulating and inhibiting the growth of lens epithelial cells. Functionality of the cells and responses to pharmacological agents can be studied by analyzing the intra- and extra-cellular calcium (Ca2+) signaling. Stimulating the growth of lens epithelial cells is important in lens regeneration while inhibiting the growth of lens epithelial cells is important in preventing the development of PCO. In the article I described the methods for the analysis of lens epithelial cells after cataract surgeries, which are carried out in the laboratory of the Eye Hospital, University Medical Centre Ljubljana.
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