Anterior capsule polishing prevents anterior capsule fibrosis after phacovitrectomy without intraocular lens implantation

Objective To investigate whether anterior capsule polishing can prevent the fibrosis of the anterior capsule in phacovitrectomy without intraocular lens (IOL) implantation. Methods and analysis A retrospective study including seventy cases of phacovitrectomy without IOL implantation was conducted. Fifty cases received 360-degree anterior capsule polishing, and 20 cases did not receive polishing. The severity of anterior capsule fibrosis was calculated by adding the score (from 0 to 3) of each clock hour. The fibrosis severity was compared in the groups with and without polishing using Mann-Whitney U test. The risk factors of anterior capsule fibrosis were explored using single and multiple linear regression. The location of secondary intraocular lens implantation was compared between the polishing and non-polishing groups with Chi-square test. Results The median severity score of the polishing group was significantly less than that of the non-polishing group (6 vs. 24 out of 36, P < 0.001). Multiple regression showed that diabetes (b = 14.634, P = 0.001), silicone oil tamponade (b = 8.734, P < 0.001), and non-polishing (b = 13.731, P < 0.001) were the risk factors of anterior capsule fibrosis. Anterior capsule polishing was associated with a higher chance of secondary in-the-bag IOL implantation (OR = 4.889, P = 0.004). Conclusion Polishing the anterior capsule is associated with reduced fibrosis of the anterior capsule in phacovitrectomy without primary IOL implantation, and more chance of secondary in-the-bag IOL implantation.