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Influence of three-piece and single-piece designs of two sharp-edge optic hydrophobic acrylic intraocular lenses on prevention of posterior capsule opacification: A prospective randomised long-term clinical trial
  1. Reda Zemaitiene (reda.zemaitiene{at}kmuk.lt),
  2. Vytautas Jasinskas (vytautas.jasinskas{at}kmuk.lt),
  3. Gerd U Auffarth (auffarthg{at}aol.com)
  1. Eye Clinic of Kaunas University of Medicine, Lithuania
  2. Eye Clinic of Kaunas University of Medicine, Lithuania
  3. Dept. of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Germany

    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 (IOL) of different haptic design 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 randomized clinical study. Thirty seven eyes of 37 patients received a 3-piece acrylic hydrophobic (AcrySof, MA3OBA, Alcon) IOL and 37 eyes of 37 patients- 1-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 1-piece acrylic hydrophobic IOL group presented more frequently than the 3-piece IOL group with capsular folds behind the IOL optic area. In the 3-piece acrylic hydrophobic IOL group PCO values of the entire IOL optic area were significantly lower six months post-OP (3-piece: 0.002±0.009; 1-piece: 0.007±0.017; P=0.04), one year post-OP (3-piece: 0.004±0.016; 1-piece: 0.026 ±0.041; P=0.001) as well as one year post-OP in the central 3-mm optic zone (3-piece: 0.000±0.0002; 1-piece: 0.019 ±0.049; P=0.001). However, two years post-OP, PCO values in both groups did not show significant differences (entire IOL optic area: 3-piece: 0.136±0.223; 1-piece: 0.154 ±0.190; P=0.18; central zone: 3-piece: 0.023±0.065; 1-piece: 0.020±0.039; P=0.44).

    Conclusion: Long-term (2-years) follow-up after cataract surgery has shown no difference in ACO and PCO development between 3-piece and 1-piece acrylic hydrophobic intraocular lenses.

    • hydrophobic acrylic
    • intraocular lens
    • posterior capsule opacification
    • single-piece
    • three-piece

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