Comparison of the incidence and visual significance of posterior capsule opacification between multifocal spherical, monofocal spherical, and monofocal aspheric intraocular lenses
Received 19 December 2008; received in revised form 28 February 2009; accepted 2 March 2009.
Purpose
To determine and compare the incidence of posterior capsule opacification (PCO) and neodymium:YAG (Nd:YAG) laser capsulotomy after implantation of 3 intraocular lens types (IOLs).
Setting
Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA.
Methods
This retrospective chart review comprised eyes having uneventful phacoemulsification and implantation of 1 of 3 AcrySof IOLs: ReSTOR SN60D3 (multifocal spherical group), Natural SN60AT (monofocal spherical group), or IQ SN60WF (monofocal aspheric group). Eyes were matched by age, sex, and follow-up. The PCO rate, Nd:YAG capsulotomy rate, time from surgery to PCO diagnosis, and time from surgery to Nd:YAG capsulotomy were assessed.
Results
Charts of 225 eyes (75 in each group) with a mean follow-up of 15.9 months ± 6.5 (SD) were evaluated. The PCO rate was 42.7% in the multifocal spherical group, 28.0% in the monofocal spherical group, and 14.7% in the monofocal aspheric group. The Nd:YAG capsulotomy rate was 25.3%, 17.3%, and 4.0%, respectively. The difference in the Nd:YAG rate was statistically significantly higher in the multifocal and monofocal spherical groups than in the monofocal aspheric group (P<.001 and P<.008, respectively) but was not significantly different between the 2 spherical IOL groups (P = .232). The time from surgery to PCO documentation was not significantly different between the 3 groups.
Conclusions
Intraocular lens configuration may have contributed to the difference in the PCO rate between the 2 spherical IOLs and the aspheric IOL. Based on the Nd:YAG rate as an indicator for visual significance, PCO may be less visually significant in eyes with the aspheric IOL than in eyes with 1 of the spherical IOLs.
From the Magill Research Center for Vision Correction, Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA
Corresponding author: Kerry D. Solomon, MD, Magill Research Center for Vision Correction, MUSC–Storm Eye Institute, 167 Ashley Avenue, Charleston, South Carolina 29425, USA.
Dr. Solomon is a consultant to Alcon Laboratories, Inc.; Allergan, Inc.; Abbott Medical Optics; Advanced Medical Research; Bausch & Lomb, Inc.; QLT; and Eyemaginations. No other author has a financial or proprietary interest in any material or method mentioned.
Presented in part at the ASCRS Symposium on Cataract, IOL and Refractive Surgery, Chicago, Illinois, USA, April 2008, and the Storm Eye/ASCRS Clinical Update 2008, Kiawah Island, South Carolina, USA, June 2008.
Supported in part by a National Institutes of Health/National Eye Institute grant 14793 (vision core), Bethesda, Maryland, and an unrestricted grant to Medical University of South Carolina–Storm Eye Institute from Research to Prevent Blindness, New York, New York, USA.
M.A. Guenena, MD, Magill Research Center, Storm Eye Institute, reviewed the literature. D. Hunter collected the data. L.R. Bartholomew, PhD, critically reviewed the paper. Alcon Laboratories provided the intraocular lens images in the figures.
ABSTRACT