Clinical Study

Eye (2007) 21, 760–763; doi:10.1038/sj.eye.6702323; published online 7 April 2006

The influence of posterior capsule opacification on scanning laser polarimetry

Competing interests: The authors have no financial or other interests in any of the products mentioned

M Vetrugno1, F Masselli1, G Greco1, D Sisto1, A Maino2, S Ficarelli1 and G Sborgia1

  1. 1Department of Ophthalmology and Otolaryngology, University of Bari, Bari, Italy
  2. 2Royal Eye Hospital, Manchester, UK

Correspondence: M Vetrugno, Dipartimento di Oftalmologia e Otorinolaringoiatria, Azienda Ospedaliera 'Policlinico', Piazza Giulio Cesare 11, 70124 Bari, Italy. Tel: +30 080 5592525; Fax: +39 080 5478918. E-mail: glaucoma@oftalmo.uniba.it

Received 22 June 2005; Accepted 28 January 2006; Published online 7 April 2006.

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Abstract

Purpose

 

To evaluate the influence of posterior capsule opacification (PCO) on GDx parameters in a population of pseudophakic, non-glaucomatous patients who underwent Nd:YAG laser capsulotomy (YLC).

Methods

 

The posterior capsules were photographed with a Topcon digital camera and each image was then entered into the EPCO 2000 software and evaluated independently by three examiners. The EPCO 2000 software was used to calculate the fibrosis index (FI) and the pearl index (PI) for the central 1.5, 2.5, and 3.5 mm of the posterior capsule. Scanning laser polarimetry was performed with GDx before and after YLC. We compared the GDx readings obtained before and after the YLC using paired Student's t-test. The parameters that varied significantly after YLC were subsequently used for regression analysis. Stepwise multiple linear regression was used to analyse the impact of the change in the amount of FI and PI on change in GDx parameters after YLC.

Results

 

In total, 158 patients were enrolled (74 men, 84 women). The mean age was 69.46plusminus8.83 years (range 46–83 years). The interobserver agreement among the three experts was found to be good (repeatability coefficient R=1.51, 1.49, 1.49 for observer A vsB, A vsC, and B vsC respectively). One-sample Student's t-test show no difference between all GDx parameters before and after YLC except for Symmetry, Superior/Nasal ratio, Inferior Ratio, and Temporal-Superior-Nasal-Inferior-Temporal (TSNIT). Stepwise multiple regression showed that the two variables of greatest significance for changes in Symmetry were the FI in the central 1.5 and the PI in the central 3.5 mm (P=0.02). Superior/nasal ratio was shown to be most strongly correlated to the FI in the central 1.5 mm and PI in the central 3.5 mm (P<0.001), whereas the variable of greatest significance to Inferior Ratio was PI in the central 3.5 mm (P=0.03). Finally, TSNIT was most strongly correlated to FI in the central 1.5 mm and FI in the central 2.5 mm (P<0.001).

Conclusion

 

Presence of capsular fibrosis seems to be more clinically relevant in the central zone, whereas pearls tend to be clinically significant in the central 3.5 mm area. Hence, it might be worthwhile assessing the amount of PCO in pseudophakic patients when performing scanning laser polarimetry. Investigators should ensure that the type of PCO and the size of the area analysed are documented in the notes in order to interpret GDx findings appropriately.

Keywords:

scanning laser polarimetry, posterior capsule opacification, laser capsulotomy

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