Histology of posterior capsular opacification

Abstract

Lens epithelial cells (LECs) undergo tissue repair reaction following cataract-intraocular lens (IOL) surgery. However, the reaction in turn produces opacification of the lens capsule that potentially impairs vision. Histology and immunohistochemistry are employed for characterization of the tissues of capsular opacification. LECs transform into regenerated lens fiber structures and myofibroblasts. The former behavior develops Soemmering's ring in the peripheral capsular bag and Elschnig's pearls on the inner surface of the posterior capsule. Histology shows lens-like cellular arrangement in these structures. The latter response is called epithelial-mesenchymal transition (EMT) and generates fibrous tissue accumulation on the capsule. EMT-derived cells no longer exhibit an epithelial feature, but accumulate fibrous extracellular matrix around themselves. Contraction of EMT myofibroblasts shrinks the postoperative lens capsule around an IOL.