Posterior capsule opacification with 3 intraocular lenses: 12-year prospective study.
OBJECTIVE
To compare posterior capsule opacification (PCO) with 3 intraocular lenses (IOLs) 12 years postoperatively.


METHODS
St. Erik Eye Hospital, Stockholm, Sweden.


METHODS
Randomized clinical trial.


METHODS
Patients having unilateral standard phacoemulsification were randomized to implantation of a round-edged heparin-surface-modified (HSM) poly(methyl methacrylate) (PMMA) IOL, a round-edged silicone IOL, or a sharp-edged hydrophobic acrylic IOL. The neodymium:YAG (Nd:YAG) capsulotomy rates and timing from surgery were recorded. Survival analysis was used to compare Nd:YAG rates. Retroillumination images were taken to evaluate PCO.


RESULTS
After 12 years, there was no significant difference in the fraction or severity of PCO between the silicone IOL and acrylic IOL. The HSM PMMA IOL had a significantly higher PCO fraction than the silicone IOL (P<.05), but not more than the acrylic IOL. There was no difference in PCO severity between the HSM PMMA IOL and the other 2 IOLs. The silicone IOL had higher median capsulotomy-free survival (>150 months) than the acrylic IOL (108 months) and the HSM PMMA IOL (53 months). Overall survival without Nd:YAG capsulotomy did not differ between the acrylic and silicone IOLs or between the silicone and HSM PMMA IOLs; however, overall survival was significantly better with the acrylic IOL than with the HSM PMMA IOL (P<.001).


CONCLUSIONS
After 12 years, there was no difference in PCO or overall survival without capsulotomy between the acrylic IOL and the silicone IOL. The HSM PMMA IOL had a significantly higher PCO fraction than the silicone IOL and lower overall survival than the acrylic IOL.
From St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden.
Margrethe
M
Rønbeck
From St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden. Electronic address: maria.kugelberg@sankterik.se.
Maria
M
Kugelberg
D000180:Acrylic Resins; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D058442:Capsule Opacification / Q000209:etiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D019904:Polymethyl Methacrylate; D057852:Posterior Capsule of the Lens / Q000473:pathology* / Q000601:surgery; D064727:Posterior Capsulotomy / Q000706:statistics & numerical data; D011446:Prospective Studies; D019591:Pseudophakia / Q000503:physiopathology; D012826:Silicone Elastomers; D014792:Visual Acuity / Q000502:physiology
D000180:Acrylic Resins; D001672:Biocompatible Materials; D012826:Silicone Elastomers; D019904:Polymethyl Methacrylate