Comparison of posterior capsule opacification development with 3 intraocular lens types: five-year prospective study.
OBJECTIVE
To compare the effects of hydrophobic acrylic, silicone, and heparin-surface-modified poly(methyl methacrylate) (HSM PMMA) intraocular lenses (IOLs) on posterior capsule opacification (PCO).


METHODS
In this 5-year prospective study, the same surgeon performed standard phacoemulsification in patients who were randomized to implantation of a round-edged HSM PMMA IOL (809C), a round-edged silicone IOL (SI-40NB), or a sharp-edged hydrophobic acrylic IOL (AcrySof MA60BM). The neodymium:YAG capsulotomy rate was recorded. To evaluate PCO and the position of the anterior capsulorhexis, retroillumination digital photographs were taken 5 years postoperatively and analyzed using the POCOman computer-analysis system.


RESULTS
After 5 years, there was no significant difference in the fraction or severity of PCO between the silicone IOLs and acrylic IOLs (both P =1.0). The silicone IOL group had a significantly higher capsulotomy rate (29%) than the acrylic IOL group (8%) (P=.0068). The HSM PMMA IOL group had a significantly higher PCO fraction, severity, and capsulotomy rate (54%) than the silicone and acrylic groups. In all eyes, the fraction (P=.0076) and severity (P=.0081) of PCO were statistically significantly higher when the anterior capsulorhexis was partly decentered than when it was completely on the optic; within each IOL group, there was no significant difference.


CONCLUSIONS
After 5 years, there was no significant difference in the semiquantitative evaluation of PCO between the sharp-edged acrylic IOL and round-edged silicone IOL. Eyes with the HSM PMMA IOL had more PCO than eyes with the other IOLs.
Rönbeck
Margrethe
M
St. Erik's Eye Hospital, Karolinska Institute, Stockholm, Sweden. margrethe.ronbeck@sankterik.se
Zetterström
Charlotta
C
Wejde
Gisela
G
Kugelberg
Maria
M
D000368:Aged; D000369:Aged, 80 and over; D019923:Capsulorhexis; D002386:Cataract / Q000209:etiology*; D006801:Humans; D057927:Hydrophobic and Hydrophilic Interactions; D053685:Laser Therapy; D007903:Lens Capsule, Crystalline / Q000473:pathology* / Q000601:surgery; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008689:Methacrylates; D008875:Middle Aged; D018918:Phacoemulsification; D011108:Polymers; D019904:Polymethyl Methacrylate; D011183:Postoperative Complications; D011446:Prospective Studies; D011474:Prosthesis Design; D012826:Silicone Elastomers
D008689:Methacrylates; D011108:Polymers; D012826:Silicone Elastomers; C104020:poly(methylmethacrylate-co-ethylhexylmethacrylate); D019904:Polymethyl Methacrylate