Anterior capsule opacification: a histopathological study comparing different IOL styles.
OBJECTIVE
To compare the degree of anterior capsule opacification (ACO) in human eyes obtained post-mortem containing various rigid and foldable posterior chamber intraocular lens (PC-IOL) designs.


METHODS
Comparative autopsy tissue study with clinicopathologic correlations.


METHODS
Four hundred sixty human globes containing the following PC-IOL styles were analyzed: (1) one-piece polymethylmethacrylate (PMMA) optic-PMMA haptic (n = 50), (2) one-piece silicone-plate IOL, large hole (n = 40), (3) one-piece silicone-plate IOL, small hole (n = 67), (4) three-piece PMMA optic-PMMA/Prolene haptic (n = 51), (5) three-piece acrylic optic-PMMA haptic (n = 96), (6) three-piece silicone optic-PMMA haptic (n = 24), (7) three-piece silicone optic-polyimide haptic (n = 40), and (8) three-piece silicone optic-prolene haptic (n = 92).


METHODS
The globes were sectioned in the equatorial plane for gross examination and then processed through paraffin; sectioned, and stained with hematoxylin-eosin, periodic acid-Schiff, and Masson's trichrome stains; and examined by light microscopy.


METHODS
Anterior capsule opacification was scored in each eye by grading the histologic sections from 0 to III, according to the amount (thickness) of proliferative tissue and cells measured in sagittal sections on the inner surface of the anterior capsule at the capsulorhexis margin.


RESULTS
The difference among the eight groups was significant (P < 0.0001). Mean ACO scores were highest with the large and small hole one-piece silicone-plate lenses (1.77 +/- 0.86 and 1.28 +/- 0.77, respectively). The lowest mean score was observed in the group of three-piece acrylic optic-PMMA haptics lenses (0.51 +/- 0.52).


CONCLUSIONS
Our results confirm previous clinical observations that the rate of ACO is relatively high with plate-haptic silicone IOLs. The lowest rate was noted with the three-piece acrylic optic-PMMA haptic IOL. The IOL design and IOL material are significant factors in the development of ACO.
Werner
L
L
Center for Research on Ocular Therapeutics and Biodevices, Storm Eye Institute, Medical University of South Carolina, Charleston, USA.
Pandey
S K
SK
Escobar-Gomez
M
M
Visessook
N
N
Peng
Q
Q
Apple
D J
DJ
D002386:Cataract / Q000473:pathology*; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D019904:Polymethyl Methacrylate; D011474:Prosthesis Design; D019591:Pseudophakia / Q000473:pathology*; D012826:Silicone Elastomers
D012826:Silicone Elastomers; D019904:Polymethyl Methacrylate