Posterior capsule opacification and neodymium:YAG laser capsulotomy rates with a round-edged silicone and a sharp-edged hydrophobic acrylic intraocular lens 10 years after surgery
Received 29 July 2008; received in revised form 18 November 2008; accepted 24 November 2008.
Purpose
To compare posterior capsule opacification (PCO) and neodymium:YAG (Nd:YAG) laser capsulotomy rates 10 years after surgery between two 3-piece intraocular lenses (IOLs): a silicone IOL with round optic edges and a hydrophobic acrylic IOL with sharp optic edges.
Setting
Department of Ophthalmology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
Methods
Patients having had cataract surgery and implantation of at least 1 study IOL by the same surgeon between 1994 and 1999 were retrospectively examined. The number of Nd:YAG laser capsulotomies performed was noted. The PCO intensity was assessed using digital retroilluminated photographs and Automated Quantification of After-Cataract (AQUA) software. The AQUA scores in eyes with Nd:YAG capsulotomy were estimated with a multiple-imputation procedure. Anterior capsule opacification (ACO) and fibrotic PCO were graded subjectively at the slitlamp.
Results
The study evaluated 143 eyes (98 patients). Eight (18%) of 44 eyes with a silicone IOL and 41 (42%) of 99 eyes with an acrylic IOL had Nd:YAG capsulotomy after 10 years (P = .007). The AQUA scores were lower with the silicone IOLs. The median difference in AQUA scores was significantly different after missing values of the Nd:YAG capsulotomies were imputed. There was no difference in ACO. There was more fibrotic PCO with round-edged silicone IOLs than with sharp-edged acrylic IOLs.
Conclusions
Ten years after surgery, acrylic IOLs seemed to lose their PCO preventive effect, despite their sharp optic edges. The increasingly longer life expectancy and earlier cataract surgery mandate reconsideration of preferences regarding optic materials and design elements of IOLs.
From the Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
Corresponding author: Rupert Menapace, MD, Department of Ophthalmology, Medical University of Vienna, Austria; Waehringer Guertel 18-20, A-1090 Vienna, Austria.
No author has a financial or proprietary interest in any material or method mentioned.
Presented in part at the XXV Congress of the European Society of Cataract & Refractive Surgeons, Stockholm, Sweden, September 2007.
ABSTRACT