[Millenniums update on posterior capsule opacification (PCO) scores, centration, biocompatibility and fixation of foldable intraocular lenses (IOL) - an analysis of 1,221 pseudophakic post mortem globes].
BACKGROUND
The ongoing and fast evolution of foldable IOL designs established the necessity to evaluate the different abilities of each lens style. The large IOL database (over 16,500 specimens) acquired in our laboratory, has permitted us to perform a clinico-pathological analysis on pseudophakic autopsy globes provided from sources worldwide, especially many Lions Eye banks in the United States.


METHODS
We analyzed 6 foldable IOL styles commonly implanted in the United States, using one type of rigid IOL design (1-piece design rigid PMMA optics) as a comparison group. Posterior capsule opacification (PCO) score, decentration, fixation, presence or absence of a Nd:YAG laser posterior capsulotomy and area and intensity of Soemmerring's ring formation was discerned by examination under an operating microscope using the Miyake-Apple posterior photographic technique.


RESULTS
The four lenses with the lowest rates ranging between 3.8 % and 21.7 % are modern designs, mostly implanted after 1992. The two lenses with the higher rates ranging between 23.1 % and 30.4 %, were all older designs, already prevalent prior to 1992. IOL fixation with both haptics in the capsular bag showed the best centration values and PCO scores. Our studies to date have shown in a preliminary fashion that the AcrySoftrade mark IOL displays the the lowest (best) biocompatibility score.


CONCLUSIONS
Entering the new millenium, with evolution of modern surgical techniques and IOL designs, the incidence of the two major complications of cataract surgery, decentration and PCO are now finally diminishing.
Schmidbauer
J M
JM
Center for Research on Ocular Therapeutic and Biodevices, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston 29425, South Carolina, USA.
Vargas
L G
LG
Apple
D J
DJ
Auffarth
G U
GU
Peng
Q
Q
Arthur
S N
SN
Escobar-Gomez
M
M
D001344:Autopsy; D001672:Biocompatible Materials / Q000009:adverse effects; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D019654:Lens Implantation, Intraocular / Q000009:adverse effects / Q000379:methods* / Q000639:trends; D007910:Lenses, Intraocular / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology*; D019591:Pseudophakia / Q000150:complications*; D012042:Registries; D014481:United States / Q000453:epidemiology
D001672:Biocompatible Materials