Effect of intraocular lens haptic compressibility on the posterior lens capsule after cataract surgery.
OBJECTIVE
To evaluate the effect of intraocular lens (IOL) haptic compressibility on the posterior capsule after cataract surgery.


METHODS
Teaching hospital, London, United Kingdom.


METHODS
In this randomized prospective study, 60 patients had standardized phacoemulsification with in-the-bag placement of a poly(methyl methacrylate) (PMMA) (Storz P497UV) or hydrogel (Storz Hydroview H60M) IOL. Both IOLs had PMMA haptics of identical configuration and length. The IOL haptic compressibility was measured in air and then during incubation in saline at 37 degrees C over 1 month. Digital retroillumination imaging was performed 1, 7, 28, 90, 180, 360, and 720 days postoperatively. The presence and duration of postoperative capsule folds were recorded and correlated with the haptic compressibility measurements, lens epithelial cell (LEC) growth patterns on the posterior capsule at 6 months, and the extent of posterior capsule opacification.


RESULTS
On the first postoperative day, 21 patients (88%) in the Hydroview group had posterior capsule folds that persisted in 12 patients (50%) for 2 years. Nineteen patients (68%) in the PMMA group had folds at day 1 (P =.01), with 1 patient (3%) still having folds at 1 month (P =.0002) and no patient having folds at 3 months. At 6 months, 11 patients (46%) in the Hydroview group and no patient in the PMMA group had LEC growth in the direction of the folds. The PMMA IOLs showed a greater decrease in haptic compressibility during incubation.


CONCLUSIONS
Haptic compressibility should be an important consideration in IOL design. The results suggest that to avoid posterior capsule folds, the compressibility should be less than 2.5 mN.
Meacock
W R
WR
Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom.
Spalton
D J
DJ
D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D015331:Cohort Studies; D019245:Compressive Strength; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D005355:Fibrosis / Q000209:etiology; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D007903:Lens Capsule, Crystalline / Q000473:pathology*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications; D011446:Prospective Studies
D001672:Biocompatible Materials; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D019904:Polymethyl Methacrylate