Efficacy of different intraocular lens materials and optic edge designs in preventing posterior capsular opacification: a meta-analysis.
OBJECTIVE
To evaluate the efficacy of different intraocular lens (IOL) materials and optic edge designs in preventing posterior capsular opacification (PCO).


METHODS
Systematic review and meta-analysis.


METHODS
Pertinent studies were selected through an electronic search of the Cochrane Library, MEDLINE, and Embase. The randomized controlled trials meeting the predefined criteria were reviewed systematically by meta-analysis. The treatment effects were measured as risk difference, and the pooled estimates were computed according to a random effect model.


RESULTS
In total, 23 randomized controlled trials were included in the present meta-analysis. The pooled risk differences of Nd:YAG laser capsulotomy rates were -24% (95% confidence interval [CI], -29% to -20%) comparing acrylic with polymethylmethacrylate (PMMA) lenses; -9% (95% CI, -17% to -1%) comparing silicone with PMMA lenses; 14% (95% CI, -8% to 36%) comparing hydrogel with PMMA lenses; 4% (95% CI, -2% to 10%) comparing silicone with acrylic lenses; 19% (95% CI, 8% to 30%) comparing hydrogel with acrylic lenses; and 28% (95% CI, 10% to 46%) comparing hydrogel with silicone lenses. The pooled risk differences of PCO rates were -39% (95% CI, -47% to -31%) comparing acrylic with PMMA lenses; -14% (95% CI, -29% to 0%) comparing silicone with acrylic lenses; 56% (95% CI, 36% to 75%) comparing hydrogel with acrylic lenses; and 48% (95% CI, 31% to 64%) comparing hydrogel with silicone lenses. When comparing sharp with rounded-edge designs, pooled risk differences of capsulotomy rates were -47% (95% CI, -77% to -17%) in PMMA lenses, -22% (95% CI, -47% to 2%) in acrylic lenses, and -9% (95% CI, -17% to 0%) in silicone lenses; pooled risk differences of PCO rates were -28% (95% CI, -50% to -7%) in acrylic lenses and -37% (95% CI, -46% to -27%) in silicone lenses.


CONCLUSIONS
The rates of PCO and Nd:YAG laser capsulotomy may be influenced by different IOL biomaterials and optic edge designs. The lenses made by acrylic and silicone and those with sharp optic edges are superior in lowering the rates of PCO and laser capsulotomy.
Cheng
Jin-Wei
JW
Department of Ophthalmology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Wei
Rui-Li
RL
Cai
Ji-Ping
JP
Xi
Gui-Lin
GL
Zhu
Huang
H
Li
You
Y
Ma
Xiao-Ye
XY
D000180:Acrylic Resins; D001672:Biocompatible Materials; D002386:Cataract / Q000517:prevention & control*; D006801:Humans; D020100:Hydrogels; D053685:Laser Therapy / Q000706:statistics & numerical data; D007903:Lens Capsule, Crystalline / Q000473:pathology* / Q000601:surgery; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D018918:Phacoemulsification; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications / Q000517:prevention & control*; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012826:Silicone Elastomers
D000180:Acrylic Resins; D001672:Biocompatible Materials; D020100:Hydrogels; D012826:Silicone Elastomers; D019904:Polymethyl Methacrylate