Neodymium:YAG capsulotomy rates following phacoemulsification with implantation of PMMA, silicone, and acrylic intraocular lenses.
OBJECTIVE
Posterior capsular opacification (PCO) is the most common visually disabling sequela of modern cataract surgery. Methods of reducing its incidence include the development of newer surgical techniques and intraocular lens (IOL) materials and designs. The aim of this study was to compare the incidence and time interval of development of PCO, and the requirement of laser capsulotomy in patients implanted with a polymethylmethacrylate (PMMA), silicone, or acrylic IOL.


METHODS
The data of 340 consecutive patients who underwent phacoemulsification and implantation ofa PMMA, silicone, or acrylic intraocular lens were analyzed. The aim of this study was to compare the incidence and time interval of development of PCO, and the requirement of laser capsulotomy in patients implanted with a PMMA, silicone, or acrylic IOL.


RESULTS
The incidence of PCO was found to be significantly less in the acrylic group (6.5% as compared to 21.74% and 26.6% in the PMMA and silicone groups, respectively; P = 0.01297 and 0.0039). Most patients (65%) exhibiting PCO in the PMMA group developed it within the first six months. In the silicone group, development of PCO was delayed. In 60% of patients, it appeared 18 months after surgery. Neodymium:YAG capsulotomy was required in 45% and 60% of patients developing PCO in the PMMA and silicone groups, respectively, while it was required in only 1 of the 4 patients developing PCO in the acrylic group.


CONCLUSIONS
This study indicates that implantation of an acrylic IOL helps reduce the incidence of PCO as well as the need for Nd:YAG capsulotomy. PMMA IOLs require Nd:YAG capsulotomy earlier in the postoperative period as compared to silicone IOLs.
Ram
J
J
Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. jagatram@cha.i91.net.in
Kaushik
S
S
Brar
G S
GS
Gupta
A
A
D000180:Acrylic Resins / Q000009:adverse effects; D001672:Biocompatible Materials / Q000009:adverse effects; D002386:Cataract / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D015994:Incidence; D053685:Laser Therapy / Q000706:statistics & numerical data*; D007903:Lens Capsule, Crystalline / Q000473:pathology / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000009:adverse effects*; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D019904:Polymethyl Methacrylate / Q000009:adverse effects; D012826:Silicone Elastomers / Q000009:adverse effects; D013997:Time Factors
D000180:Acrylic Resins; D001672:Biocompatible Materials; D012826:Silicone Elastomers; D019904:Polymethyl Methacrylate