Nd:YAG laser capsulotomy rates following implantation of square-edged intraocular lenses: polymethyl methacrylate versus silicone versus acrylic.
OBJECTIVE
To study the influence of square-edged intraocular lenses (IOLs) on the development of posterior capsule opacification (PCO) and the requirement for laser capsulotomy.


METHODS
Retrospective study.


METHODS
Three hundred seventy-seven eyes of 377 patients were included.


METHODS
All these patients underwent phacoemulsification and implantation of square polymethyl methacrylate (PMMA) (Aurolab), silicone (Tecnis Z9000), acrylic hydrophobic (AcrySof MA60AC and Sensar Optiedge), or acrylic hydrophilic (Akreos Adapt) IOLs with a minimum of 2 years' follow-up. Only those cases in which Nd:YAG laser capsulotomy had been performed for visually significant PCO were evaluated.


RESULTS
Three hundred seventy-seven eyes of 377 patients were included in the study. Follow-up duration ranged from 24 to 54 (mean 40.27, SD 8.42) months. The incidence of PCO requiring Nd:YAG laser capsulotomy was found to be significantly less in the silicone lens group: 1.4% as compared with an incidence of 11.7% in the PMMA lens group (p = 0.018). In the square-edged acrylic group, visually significant PCO requiring Nd:YAG laser capsulotomy was observed in 3.6%, 4.8%, and 6.8% of eyes implanted with AcrySof MA60AC, Sensar Optiedge, and Akreos Adapt IOLs, respectively. In 5 of the 7 eyes (71.4%) exhibiting PCO in the PMMA group, the condition developed within the first 6 months. In the silicone and acrylic group, development of PCO was delayed.


CONCLUSIONS
The rate of visually significant PCO as well as the need for Nd:YAG laser capsulotomy is influenced by IOL biomaterial in addition to square edge. It is significantly delayed with square-edged foldable acrylic and silicone IOLs compared with square-edged PMMA IOLs.
Ram
Jagat
J
Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. drjagatram@yahoo.com
Kumar
Sunil
S
Sukhija
Jaspreet
J
Severia
Saurabh
S
D000180:Acrylic Resins / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000009:adverse effects*; D002386:Cataract / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D007903:Lens Capsule, Crystalline / Q000473:pathology* / Q000601:surgery; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D019904:Polymethyl Methacrylate / Q000009:adverse effects; D011183:Postoperative Complications; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D012826:Silicone Elastomers / Q000009:adverse effects
D000180:Acrylic Resins; D001672:Biocompatible Materials; D012826:Silicone Elastomers; D019904:Polymethyl Methacrylate