Elschnig’s Pearls
Posterior capsule opacification is the most common complication of cataract surgery.
Lens Epithelial Cells → Migration → Proliferation → Differentiation
Two types of PCO:
Fibrous Abnormal proliferation of LEC → presents as wrinkles and folds on the posterior capsule site at the fusion of anterior and posterior capsules
Proliferative → Elsching’s Pearls
Elsching’s Pearls result from aberrant attempts by lens cells attached to the capsule to form new lens fibres
Normally differentiated LEC that line the equatorial lens region migrate and proliferate between posterior capsule and the IOL
Clusters of residual LEC appear as round, clear pearls that shine on retro-illumination → Appearance of a bunch of grapes/ soap bubbles/ mass of fish eggs
Decreased visual acuity if they accumulate on visual axis
Histology:
Large clear lens cells (bladder cells) are seen behind iris, pupillary space or both areas
Treatment:
Nd:YAG Laser Capsulotomy
Image from Rajan Eye Care Hospital