PURPOSE: To observe and document the daily changes in the morphology of Elschnig pearls. DESIGN: A prospective cohort study. METHODS: Twenty-nine pseudophakic eyes with pronounced,regeneratory posterior capsule opacification (PCO) were included in this prospective study. Retroillumination images were taken at days 0,1,2,and 14. A square grid was laid over the images. Increase,decrease,appearance,and disappearance of pearls between the follow-up images were quantified. RESULTS: A total of 1371 areas (mean: 53/eye)-of 26 eyes were analyzed between days 0 and 1 and 1 and 2,and 896 areas (50/eye) of 18 eyes between days 0 and 14. Between days 0 and 1,days 1 and 2,and days 0 and 14,we observed “no change” in pearl size in 72% ,77% ,and 32% ,a “minor increase” in 16% ,14% ,and 10% ,a “major increase” in 4% ,3% ,and 42% ,a “minor decrease” in 14% ,11% ,and 11% ,and a “major decrease” in 4% ,3% ,and 37% ,respectively. Appearance of newly formed pearls was found in 1% ,1% ,and 9% and disappearance of pearls in 1% ,1% ,and 5% ,respectively. CONCLUSIONS: Significant changes in the morphology of Elschnig pearls were observed within time intervals of only 24 hours. Appearance and disappearance of pearls,as well as progression and regression of pearls within these short intervals illustrate the dynamic behavior of regeneratory PCO. These findings may contribute to a better understanding of PCO and have implications on pharmaceutical interventions for PCO. PURPOSE: To observe and document the daily changes in the morphology of Elschnig pearls. DESIGN: A prospective cohort study. METHODS: Twenty-nine pseudophakic eyes with pronounced, regeneratory posterior capsule opacification (PCO) were included in this prospective study. Retroillumination images were Increase, decrease, appearance, and disappearance of pearls between the follow-up images were quantified. RESULTS: A total of 1371 areas (mean: 53 / eye) -of 26 eyes were analyzed between days 0 and 1 and 1 and 2, and 896 areas (50 / eye) of 18 eyes between days 0 and 14 Between days 0 and 1, days 1 and 2, and days 0 and 14, we observed “no change ” in pearl size in 72%, 77%, and 32%, a “minor increase ” in 16%, 14%, and 10% “In 4%, 3%, and 42%, respectively, a” minor decrease “in 14%, 11%, and 11%, and a” major decrease "in 4%, 3%, and 37% Appearance of newly formed pearls was found in 1%, 1%, and 9% and disappearance of pearls in 1%, 1%, and 5%, respectively. CONCLUSIONS: Significant changes in the morphology of Elschnig pearls were observed within time intervals of only 24 hours. Appearance and disappearance of pearls, as well as progression and regression of pearls within these short intervals illustrate the dynamic behavior of regeneratory PCO. These findings may contribute to a better understanding of PCO and have implications on pharmaceutical interventions for PCO.