IntroductionPosterior capsule opacification (PCO) still remains one of the major complications in cataract surgery. Problems especially emerge with the design of accommodative and multifocal intraocular lens (IOL). For proper function these IOLs require elastic lens capsules without any tendency of after cataract formation to avoid reduced mobility of the IOL and IOL decentration. Furthermore future concepts of presbyopia correction such as injectable IOL materials also highly depend on elastic lens capsules without any capsule opacification.Material and methodsThe most accepted concept of PCO prevention today is the sharp edge design of an IOL. The sharp edge independently of IOL material can inhibit PCO development. Other current investigated strategies focus on the genetic and pharmacological manipulation of lens epithelial cells (LEC) or on the removal of these cells. A newin vitroPCO model for testing new strategies and substances which could influence LEC growth will be presented. This model is based on the stabilisation of the capsular bag by a capsular tension ring (CTR). It offers excellent stabilisation of the capsule and physiological conditions in organ culture. The influence of different CTRs on PCO was evaluated. We found, that CTRs do not completely prevent PCO developmentin vitro, however different CTR designs show different shapes of capsule expansion and different pattern of LEC growth. Cystamine, β-lactose and alkylphosphocholine, all antiproliferative but non toxic substrates were tested: Although none of the substances evaluated could fully prevent LEC migration in thein vitroPCO model, β-lactose and alkylphosphocholine were highly effective in delaying LEC migration on the capsule bag when compared to untreated LEC. In a third approach the laser photolysis system of A.R.C Laser^®was adapted for capsule polishing by ablation of LEC. After cataract extraction multiple laser pulses were applied to mechanically remove LEC. The lowest efficient energy necessary for removal of LEC was evaluated in thein vitromodel.ConclusionThe introducedin vitromodel offers an easy and safe way to investigate the impact of innovative approaches on PCO prevention.