1 Mekanisme terjadinya PCO

PCO terjadi karena adanya proliferasi dan migrasi dari sisa sel epitel lensa (LEC), fibroblast, makrofag
pada kapsul posterior. Semua proses tersebut dipicu oleh sitokin, growth factor dan protein matriks
ekstraselular.

2 Komplikasi YAG laser

Though reliable, Nd:YAG capsulotomy can lead to complications like spike in IOP, lens
damage, change in refraction, macular edema, retinal tear, and retinal detachment. 7–
16
 The most common complication of Nd:YAG laser posterior capsulotomy is
increased IOP. In the absence of antiglaucoma or anti-inflammatory
prophylaxis, 59–67% of patients showed IOP increment of at least 10 mm Hg
following Nd:YAG laser capsulotomy.29,30 Despite the prophylactic treatment,
increased IOP was reported in 15–30% of patients in several studies.

3 Limitasi atau keterbatasan penelitian ini

Pada penelitian ini tidak dinilai staging dari diabetic retinopati dan nilai dari glukosa darah. Follow up
setelah Tindakan operasi katarak juga bervariasi pada setiap pasien, kurang lebih berkisar antara 18
bulan – 34 bulan pasca operasi.

4 Pasien usia muda > usia tua

5. Jawaban

Perbandingan angka kejadian PCO dikarenakan penggunaan Teknik operasi ECCE atau
fakoemulsifikasi masih kontraversial, namun dalam penelitian ini dan beberapa penelitian yang
serupa mengatakan bahwa fakoemulsifikasi dan I/A korteks dapat membuat konsentrasi residu LEC
menjadi lebih sedikit pada permukaan kapsul internal dibandingkan ECCE

6. Jawaban

After combined surgery, eyes can also develop severe postoperative inflammation.4,5 This
inflammation probably leads to more extensive PCO. Lens epithelial cells (LECs) proliferate in
response to many factors, one of which is inflammation. It has been suggested that surgical trauma
stimulates residual LECs to produce cytokines such as interleukin-1 (IL-1), IL-6, IL-8, basic fibroblast
growth factor, and transforming growth factor-b. These cytokines may play an important role in
fibrous proliferation of LECs via an autocrine pathway, paracrine pathway, or both.6,7 The degree of
postoperative inflammation appears to be related to PCO development.

Junko Toda, Satoshi Kato, Tetsuro Oshika, Gentaro Sugita, Posterior capsule opacification after
combined cataract surgery and vitrectomy, Journal of Cataract & Refractive Surgery, Volume 33,
Issue 1, 2007, Pages 104-107, ISSN 0886-3350, https://doi.org/10.1016/j.jcrs.2006.09.018.

7. Jawaban

As factors associated with IOL, the importance of square-edged optic design which creates a sharp
bend in the posterior capsule, preventing lens epithelial cell migration, has been pointed out by Nishi
and coauthors (16). Ursell et al emphasized the importance of IOL material in the pathogenesis of
PCO and showed that IOLs made from acrylic polymer were associated with a significantly reduced
degree of PCO compared with those from PMMA and silicone (17). Acrylic IOL was also known for its
strong adhesiveness to a collagen membrane (18). This leads to increase the contact of IOL to
posterior or anterior capsules and can be another possible reason why it may cause less PCO.