Effect of anterior capsule polishing on fibrotic capsule opacification: three-year results.
OBJECTIVE
To evaluate the long-term effect of anterior capsule polishing on anterior capsule opacification (ACO) and peripheral fibrotic posterior capsule opacification (PCO).


METHODS
Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.


METHODS
This randomized double-blind study comprised 104 eyes of 52 patients with bilateral age-related cataract. All patients received round-edged intraocular lenses (IOLs); 26 received an SI-40 IOL (Advanced Medical Optics Inc.) in both eyes, and 26 received a Silens6 IOL (Domilens) in both eyes. Both IOLs consist of different silicone material and have different haptic angulation. The SI-40 IOL has 13.0 mm open-loop poly(methyl methacrylate) (PMMA) haptics angulated by 10 degrees. The Silens6 IOL has 12.5 mm open-loop PMMA haptics with no angulation. In 1 eye, the anterior capsule was extensively polished. The anterior capsule was left unpolished in the contralateral eye, which acted as a control. Digital slitlamp photographs of the ACO and fibrotic PCO were taken with a standardized technique for 3 years postoperatively. The intensity of ACO was measured objectively (score 0% to 100%) using Adobe Photoshop software. Fibrotic PCO was graded subjectively (score 0 to 4).


RESULTS
The mean ACO was 17% in the polished eyes and 26% in the control eyes (P = .0001). The mean fibrotic PCO score was 0.5 and 1.0, respectively (P = .0007). The mean ACO was 15% in the polished SI-40 eyes and 26% in the control SI-40 eyes (P = .01). It was 19% in the polished Silens6 eyes and 26% in the control Silens6 eyes (P = .003). The mean fibrotic PCO score was 0.4 in the polished SI-40 eyes and 1.1 in the control SI-40 eyes (P = .0006). It was 0.6 in the polished Silens6 eyes and 0.9 in the control Silens6 eyes (P = .08).


CONCLUSIONS
Three years after surgery, eyes in which the anterior capsule was extensively polished had less ACO and fibrotic PCO with both round-edged silicone IOLs. In eyes with Silens6 IOLs, however, the reduction in fibrotic PCO was not significant.
Sacu
Stefan
S
Department of Ophthalmology, Medical University of Vienna, Medical School, Vienna, Austria.
Menapace
Rupert
R
Wirtitsch
Matthias
M
Buehl
Wolf
W
Rainer
Georg
G
Findl
Oliver
O
D000368:Aged; D019923:Capsulorhexis; D002386:Cataract / Q000209:etiology*; D004311:Double-Blind Method; D004847:Epithelial Cells / Q000473:pathology; D005355:Fibrosis; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007903:Lens Capsule, Crystalline / Q000473:pathology* / Q000601:surgery*; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D018918:Phacoemulsification; D011446:Prospective Studies; D011474:Prosthesis Design; D012826:Silicone Elastomers; D013396:Suction / Q000379:methods*
D012826:Silicone Elastomers