Aim: To evaluate the influence of hydrophilic and hydrophobic acrylic material and haptic angulation on anterior capsule opacification.
Methods: Prospective study on 53 patients with bilateral age-related cataract. Patients underwent standard cataract surgery by the same surgeon and randomly received a hydrophilic acrylic IOL in one eye and a hydrophobic acrylic IOL in the fellow eye. Forty- five of these patients completed the one-year follow-up. The following parameters were assessed: decentration, buttonholing, antero-lenticular gap (ALG), anterior capsule opacification (ACO) intensity and pattern, outgrowth and refractive outcome.
Results: At the one-year follow-up, ACO was seen in 80% of the hydrophilic and 100% of the hydrophobic IOLs. ACO was more intense in the hydrophobic IOLs (p<0.001). Diffuse ACO occurred in 33% of the hydrophilic and 87% of the hydrophobic IOL (p<0.001). ACO of the rhexis-edge (33% hydrophilic and 13% hydrophobic) was not significantly different between the groups. Outgrowth was seen in 42% of the hydrophilic and 2% of the hydrophobic IOLs (p=0.0003). No case of persisting ALG was seen in the hydrophobic, but in 42% of the hydrophilic IOLs. The refractive outcome was- 0.29±0.56 D for the hydrophilic and 0.003± 0.44 D for the hydrophobic IOLs (p<0.001).
Conclusion: These results suggest that there is less ACO in hydrophilic acrylic than in hydrophobic acrylic IOLs. While material properties might play a role, the angulated haptics of the hydrophilic IOLs exert an additional effect via the persisting ALG and a lack of contact between the IOL and the anterior capsule.
- acrylic intraocular lens
- anterior capsule opacification
- haptic angulation
- hydrophilic acrylic IOL