Posterior capsular opacification in phacotrabeculectomy : a long-term comparative study of silicone versus acrylic intraocular lens.
OBJECTIVE
To investigate the long-term outcomes of silicone versus acrylic intraocular lens (IOL) implantation in phacotrabeculectomy (PT) with special emphasis on posterior capsular opacification.


METHODS
Long-term follow-up on prior 1-year prospective, randomized study.


METHODS
A total of 200 eyes of 200 consecutive primary open-angle glaucoma patients who had undergone primary PT with capsular bag implantation of either a silicone IOL (102 eyes) or an acrylic IOL (98 eyes) according to the initial short-term prospective, randomized study protocol.


METHODS
The study eyes underwent primary trabeculectomy, phacoemulsification, and posterior chamber IOL implantation. Adjunctive mitomycin C was used selectively, primarily in patients with one or more risk factors for filtration failure.


METHODS
Incidence of posterior capsular opacification (PCO), best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of pressure-lowering medications, and filtration success rates, defined as maintenance of target IOP while on one (criteria 1) or zero (criteria 2) pressure-lowering medications without further surgical intervention.


RESULTS
At 3-year follow-up, the PCO rate and BCVA did not differ significantly between the two groups (P: > 0.05 for both). In addition, there were no significant differences in IOP, number of medications, and filtration success rate between the two groups (P: > 0.05 for each).


CONCLUSIONS
There were no significant long-term differences between the silicone and acrylic IOL groups in PCO, BCVA, IOP, number of medications, and success of filtration surgery after PT. Both groups attained significant improvement in BCVA and IOP control after surgery.
Ober
M D
MD
Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan 48201-1423, USA.
Lemon
L C
LC
Shin
D H
DH
Nootheti
P
P
Cha
S C
SC
Kim
P H
PH
D000180:Acrylic Resins; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000209:etiology* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000601:surgery; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D018918:Phacoemulsification / Q000009:adverse effects*; D011446:Prospective Studies; D012826:Silicone Elastomers; D014130:Trabeculectomy / Q000009:adverse effects*; D014792:Visual Acuity
D000180:Acrylic Resins; D012826:Silicone Elastomers; D016685:Mitomycin