Role of the posterior capsule in the aqueous-vitreous barrier in aphakic and pseudophakic eyes

Clinical observations have shown that an intact posterior capsule between aqueous and vitreous may function as a barrier to low and high molecular weight substances, e.g., prostaglandins or the angiogenic factor. To determine if this protective barrier breaks down after posterior capsulotomy, we examined the distribution of fluorescein in human eyes after intracapsular cataract extraction (ICCE), extracapsular cataract extraction (ECCE) and intraocular lens (IOL) implantation with capsulotomy, and ECCE and IOL implantation without capsulotomy in 12 patients each. After ICCE and after ECCE and IOL implantation with capsulotomy, diffusion of fluorescein into the vitreous showed similar values. These values were significantly higher than those obtained in patients after ECCE or ECCE and IOL implantation without capsulotomy. This leads us to believe that an intact posterior capsule prevents the diffusion of soluble substances.