Risk factors for contraction of the anterior capsule opening after cataract surgery

Abstract
Purpose: To investigate the factors contributing to contraction of the anterior capsule opening (ACO) after cataract surgery in normal eyes. Setting: Department of Ophthalmology, University of Tokyo, School of Medicine, Tokyo, and Kaiya Eye Clinic, Hamamatsu, Japan. Methods: This study included 141 eyes of 141 patients scheduled to have cataract surgery. The area of the ACO was determined by diaphanoscopy using the EAS-1000 anterior eye segment analysis system 1 day and 9 months postoperatively, after which the percentage reduction in the ACO area was calculated. Aqueous flare intensity was measured with a laser flare-cell meter 1 week and 9 months after surgery. Multiple regression analysis was performed to determine which factors were correlated with the percentage reduction in the ACO area. Variables tested included patient age, axial length, the ACO area on the first postoperative day, and flare values 1 week and 9 months after surgery. Results: Patient age (r = 0.193, P = .029) and flare intensity 9 months after surgery (r = 0.255, P = .007) were significantly correlated with the percentage reduction in the ACO area (R2 = 0.133). The axial length, ACO area 1 day postoperatively, and flare value at 1 week were not correlated with ACO contraction. Conclusion: Contraction of the ACO after cataract surgery is related to instability of the blood-aqueous barrier.