Comparison of posterior capsule opacification development with 3 intraocular lens types: Five-year prospective study
Received 21 February 2009; received in revised form 7 May 2009; accepted 8 May 2009.
Purpose
To compare the effects of hydrophobic acrylic, silicone, and heparin-surface-modified poly(methyl methacrylate) (HSM PMMA) intraocular lenses (IOLs) on posterior capsule opacification (PCO).
Methods
In this 5-year prospective study, the same surgeon performed standard phacoemulsification in patients who were randomized to implantation of a round-edged HSM PMMA IOL (809C), a round-edged silicone IOL (SI-40NB), or a sharp-edged hydrophobic acrylic IOL (AcrySof MA60BM). The neodymium:YAG capsulotomy rate was recorded. To evaluate PCO and the position of the anterior capsulorhexis, retroillumination digital photographs were taken 5 years postoperatively and analyzed using the POCOman computer-analysis system.
Results
After 5 years, there was no significant difference in the fraction or severity of PCO between the silicone IOLs and acrylic IOLs (both P =1.0). The silicone IOL group had a significantly higher capsulotomy rate (29%) than the acrylic IOL group (8%) (P=.0068). The HSM PMMA IOL group had a significantly higher PCO fraction, severity, and capsulotomy rate (54%) than the silicone and acrylic groups. In all eyes, the fraction (P=.0076) and severity (P=.0081) of PCO were statistically significantly higher when the anterior capsulorhexis was partly decentered than when it was completely on the optic; within each IOL group, there was no significant difference.
Conclusion
After 5 years, there was no significant difference in the semiquantitative evaluation of PCO between the sharp-edged acrylic IOL and round-edged silicone IOL. Eyes with the HSM PMMA IOL had more PCO than eyes with the other IOLs.
From St. Erik's Eye Hospital (Rönbeck, Wejde, Kugelberg), Karolinska Institute, Stockholm, Sweden, and the Department of Ophthalmology (Zetterström), University of Oslo, Norway
Corresponding author: Margrethe Rönbeck, MD, St. Erik's Eye Hospital, SE-112 82 Stockholm, Sweden.
No author has a financial or proprietary interest in any material or method mentioned.
Financial support provided through the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and the Karolinska Institute. Supported by grants from Stiftelsen Synfrämjandets Forskningsfond, Stockholm, Sweden.
ABSTRACT