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Influence of three-piece and single-piece designs of two sharp-edge optic hydrophobic acrylic intraocular lenses on the prevention of posterior capsule opacification: a prospective, randomised, long-term clinical trial
  1. Reda Zemaitiene1,
  2. Vytautas Jasinskas1,
  3. Gerd U Auffarth2
  1. 1Eye Clinic of Kaunas University of Medicine, Kaunas, Lithuania
  2. 2Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
  1. Correspondence to: Reda Zemaitiene MD, PhD, Eye Clinic of Kaunas University of Medicine, Mickeviciaus 9, LT 44307 Kaunas, Lithuania; reda.zemaitiene{at}kmuk.lt

Abstract

Background: Posterior capsule opacification (PCO) is still a major long-term complication of modern cataract surgery. We evaluated the impact of sharp-edged intraocular lenses (IOLs) with different haptic designs made from the same hydrophobic acrylic material on posterior and anterior lens capsule opacification.

Setting: Eye clinic of Kaunas University of Medicine, Lithuania. Prospective randomised clinical study.

Methods: Seventy-four eyes of 74 patients scheduled for cataract surgery were included in a prospective randomised clinical study. Thirty-seven eyes of 37 patients received a three-piece acrylic hydrophobic (AcrySof, MA3OBA, Alcon) IOL; and thirty-seven eyes of 37 patients received a one-piece acrylic hydrophobic (AcrySof, SA3OAL, Alcon) IOL. Visual acuity, anterior capsule opacification (ACO), capsular folds, capsulorrhexis/optic overlapping and posterior capsule opacification (PCO) were evaluated. ACO was assessed subjectively. PCO values in the entire IOL optic area and in the central 3 mm optic zone were assessed using a photographic image-analysis system (EPCO2000). Follow-ups were performed postoperatively at 1 day, 6 months, 1 year and 2 years.

Results: There were no significant differences in best corrected visual acuity, grade of ACO and capsulorrhexis/optic overlapping between IOL types during the follow-up period. Patients in the one-piece acrylic hydrophobic IOL group more frequently presented with capsular folds behind the IOL optic area than those in the three-piece IOL group. In the three-piece acrylic hydrophobic IOL group, PCO values (mean (SD)) of the entire IOL optic area were significantly lower six months postoperative (three-piece: 0.002 (0.009); one-piece: 0.007 (0.017); p = 0.04), one year postoperative (three-piece: 0.004 (0.016); one-piece: 0.026 (0.041); p = 0.001) as well as one year postoperative in the central 3 mm optic zone (three-piece: 0.000 (0.0002); one-piece: 0.019 (0.049); p = 0.001). However, two years postoperative, the PCO values of the groups did not show significant differences (entire IOL optic area: three-piece, 0.136 (0.223); one-piece, 0.154 (0.190); p = 0.18; central zone: three-piece, 0.023 (0.065); one-piece: 0.020 (0.039); p = 0.44).

Conclusion: The 2 year follow-up after cataract surgery showed no significant difference in ACO and PCO development between three-piece and one-piece acrylic hydrophobic intraocular lenses.

  • ACO, anterior capsule opacification
  • IOL, intraocular lens
  • LEC, lens epithelial cell
  • PCO, posterior capsule opacification
  • posterior capsule opacification
  • intraocular lens
  • hydrophobic acrylic
  • single-piece
  • three-piece
  • ACO, anterior capsule opacification
  • IOL, intraocular lens
  • LEC, lens epithelial cell
  • PCO, posterior capsule opacification
  • posterior capsule opacification
  • intraocular lens
  • hydrophobic acrylic
  • single-piece
  • three-piece

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Footnotes

  • Published Online First 22 November 2006

  • Competing interests: None.

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