Do we have any effective measure to minimize PCO?

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In the past, posterior capsular opacification (PCO) was considered an inevitable, albeit relatively minor complication of cataract surgery. As technology has improved, the qualities of lens implants have changed. Multifocal intraocular lenses confer visual benefits but the optics are dependent upon a clear optical medium and accurate placement. The development of PCO can distort the centration and function of these advanced optical qualities, such as diffractive rings, rendering lenses suboptimal and in some cases intolerable. Therefore long-term quality outcomes are dependent on predictability and stability. The Bag-in-the-lens (BIL) implant is currently the most effective measure to prevent PCO. The technique depends on the construction of two comparable anterior and posterior capsulorhexes. The lens is suspended centrally, supported by the integrity of the capsule and seals away lens epithelial cells preventing postoperative opacification. This placement has also been proven to be highly resistant to decentration and rotation. As the uptake of multifocal lenses and patient expectations increase, we propose that the BIL approach is currently the most stable and dependable means of ensuring quality long-term multifocal outcomes.

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