Objective: Despite recent improvements in IOL design, posterior capsule opacification (PCO) remains a significant clinical problem after cataract surgery. The Perfect Capsule device (Milvella, Ltd., Epping, Australia) permits the introduction and subsequent removal of potentially toxic agents into the closed capsular bag. The present purpose was to detect the effectiveness of arsenic trioxide (As2O3) to cultured human lens cells and cells within the human capsular bag.

Methods: All experiments were carried out with 2 minutes exposure to As2O3. Effect of As2O3 on FHL124 cells growth was tested by MTT. Changes in cell calcium levels induced by high concentration of As2O3 were measured by real-time fluorometric single-cell digital imaging techniques after Fura-2 incorporation. In vitro human capsular bags were also tested after a sham surgery was performed using the Perfect Capsule device to form a closed system. As2O3 (10, 30, 100, 300, 1000 µmol/L) were used with donor match-pairs treated with medium alone.(n = 3 in all cases).On-going observations were by phase-contrast microscopy. Cellular architecture was examined by fluorescence cytochemistry.

Results: As2O3 of 100 µmol/L and above inhibited the growth of FHL 124 cells in a dose-dependent manner with 2 minutes exposure (t = 5.217, P < 0.01, IC(50) is 130 µmol/L) As2O3 depleted the calcium store and consequently lead to a loss of calcium signaling.Moreover, 1 × 10(4) µmol/L As2O3 had a moderate effect on the calcium influx pathway, inhibition on the amplitude and rapidity is (43.24 ± 2.98)% (t = 3.134, P < 0.01) and (46.27 ± 6.01)% (t = 3.521, P < 0.01), respectively. No cell left in the vitro human capsular bags after being treated with 1 × 10(4) µmol/L As2O3.

Conclusions: As2O3 can eliminate the human lens epithelium cells remained in the capsular bag in cataract surgery, which may help to prevent PCO. The application of As2O3 to cells within the capsular bag for a 2 minute window using the Perfect Capsule system predicts this compound will have therapeutic benefit to humans in vivo.

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