Elsevier

Ophthalmology

Volume 112, Issue 9, September 2005, Pages 1550-1556
Ophthalmology

Original article
Posterior Capsule Opacification in the Presence of an Intraocular Lens with a Sharp versus Rounded Optic Edge

https://doi.org/10.1016/j.ophtha.2005.03.024Get rights and content

Purpose

To compare the degree of posterior capsule opacification (PCO) and visual function in eyes implanted with an acrylic intraocular lens (IOL) with a sharp posterior optic edge with that in eyes implanted with an IOL with a rounded optic edge.

Participants

Seventy-five consecutive patients scheduled for bilateral phacoemulsification were assigned randomly to 1 of 2 groups. One group received an acrylic IOL with a sharp edge (Sensar AR40e, AMO, Santa Ana, CA) in the left eye and an acrylic IOL of the same optic material and loops but with a rounded-edge optic (Sensar AR40) in the right eye. The other group received the sharp-edged IOL in the right eye and the rounded-edge IOL in the left eye. Sixty-nine patients (92%) completed follow-up.

Intervention

All patients underwent implantation of a sharp-edged IOL in 1 eye and a rounded-edge IOL in the fellow eye.

Main Outcome Measures

The PCO value of these patients was measured using the Scheimpflug videophotography system at 1, 3, 6, 12, 18, and 24 months after surgery. The incidence of eyes that required a neodymium:yttrium–aluminum–garnet (Nd:YAG) laser posterior capsulotomy was examined. Visual acuity and contrast sensitivity with and without a glare source also were evaluated.

Results

The mean PCO value in the sharp-edge IOL group was significantly less than that in the rounded-edge IOL group throughout the follow-up period. The incidence of Nd:YAG capsulotomy also was significantly less in the sharp-edge group than in the rounded-edge group (P = 0.0095). No significant difference was found in mean visual acuity during the 24 months of follow-up. However, contrast visual acuity with and without glare was significantly better in the sharp-edge group than in the rounded-edge group at 24 months after surgery.

Conclusions

The degree of posterior capsule opacification in eyes with an acrylic IOL with a sharp posterior optic edge is significantly less than that in eyes with a rounded-edge IOL, and the sharp-edge optic led to better contrast sensitivity with and without glare.

Section snippets

Patients

All patients who were admitted consecutively to the Hayashi Eye Hospital for bilateral cataract surgery between October 2001 and March 2002 were screened by a clinical research coordinator. Exclusion criteria were ocular pathologic features other than senile cataract, history of prior ocular surgery or inflammation, eyes scheduled for planned extracapsular cataract extraction with nucleus expression, a pupil diameter less than 6.0 mm after full dilation, patients with diabetes mellitus, and

Results

The participant flow in this study is shown in Figure 2. Because the surgical procedures were the same for the 2 IOLs, patients were not aware of the type of IOL implanted. The surgeon and examiners also were unaware of the type of IOL used because the 2 IOLs are similar in appearance. Furthermore, because the controller of this clinical trial kept concealed the assignment schedule until the end of the study, the data analyst, who was also the surgeon, did not know the type of IOL used. During

Discussion

Our study demonstrated that the degree of PCO in eyes that received an acrylic IOL with a sharp posterior optic edge did not progress, whereas PCO in eyes that received a rounded-edge acrylic IOL showed a marginal (albeit statistically significant) increase. Consequently, the degree of PCO associated with a sharp-edge IOL was significantly less than that with a rounded-edge IOL. Furthermore, the incidence of Nd:YAG laser posterior capsulotomy was significantly less in eyes with the sharp-edge

References (37)

Cited by (87)

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    Citation Excerpt :

    Infiltration of capsular epithelial cells8 or development of nanometer-ordered glistenings6 increases light scatterings on the posterior or both IOL surfaces, respectively. The anterior-segment analyzer EAS-1000 (Nidek), which has been used frequently in previous studies,5,9–15 captures Scheimpflug images at a particular meridian under slit illumination from a flash lamp and analyzes the densitometry in the area of interest. This measurement also has been used for glistenings.7,9

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Manuscript no. 2005-45.

The authors have no proprietary interest in any of the materials mentioned in the article and have received no financial support.

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