Elschnig pearls are caused by residual lens epithelial cells (LECs) after cataract surgery.
Here's a breakdown of the process:
- Residual LECs: After cataract surgery, some equatorial lens epithelial cells (LECs) can remain in the eye. These cells are located in the lens periphery.
- Migration and Proliferation: These residual LECs migrate between the posterior capsule (the back part of the lens capsule that remains after surgery) and the intraocular lens (IOL, the artificial lens implanted during cataract surgery). They then start to multiply.
- PCO Formation: The LECs first form a syncytial posterior capsule opacification (PCO).
- Elschnig Pearl Formation: Over time, the PCO progresses into Elschnig pearls. These pearls are clusters of swollen, degenerate LECs that appear like small, glistening spheres.
- Visual Impact: This process leads to a decrease in visual acuity and a loss of contrast sensitivity.
In essence, Elschnig pearls are a common form of posterior capsule opacification resulting from the proliferation of leftover lens cells after cataract surgery.
