Human lens cell growth on the capsular bag in serum free medium

Purpose: To investigate factors that influence lens epithelial cell growth on the posterior capsule and intraocular lens (IOL) after cataract surgery using an in vitro capsular bag model. Methods: A sham cataract operation was performed on human donor eyes. An IOL could be implanted if required. The capsular bag was dissected free, pinned flat on a petri dish and incubated with EMEM alone or EMEM supplemented with 10% FCS. Observations were made by phase and darkfield microscopy for up to 200 days. At the end point capsules were studied by immunohistochemistry. Results: After a delay, cells could be seen growing on the posterior capsule, both in the presence and absence of serum. The rate of growth was shown to be age dependent. This effect was more pronounced in serum free cultures such that the posterior capsule was totally covered by a confluent monolayer after 8.0±0 (3) days and 24.4±5.3 (8) days for capsules aged <40 years and >60 years respectively. Complete cover of the IOL was always achieved in serum cultures, but never attained in the absence of serum. Conclusions: Cell growth proceeds to confluency on the posterior capsule in the absence of serum, but is less prolific on the anterior IOL. The resilient cell growth on the capsule explains the high prevalence of PCO following extracapsular cataract surgery.