Efficacy of different intraocular lens materials and optic edge designs in preventing posterior capsular opacification: a meta-analysis

Am J Ophthalmol. 2007 Mar;143(3):428-36. doi: 10.1016/j.ajo.2006.11.045. Epub 2006 Dec 28.

Abstract

Purpose: To evaluate the efficacy of different intraocular lens (IOL) materials and optic edge designs in preventing posterior capsular opacification (PCO).

Design: Systematic review and meta-analysis.

Methods: Pertinent studies were selected through an electronic search of the Cochrane Library, MEDLINE, and Embase. The randomized controlled trials meeting the predefined criteria were reviewed systematically by meta-analysis. The treatment effects were measured as risk difference, and the pooled estimates were computed according to a random effect model.

Results: In total, 23 randomized controlled trials were included in the present meta-analysis. The pooled risk differences of Nd:YAG laser capsulotomy rates were -24% (95% confidence interval [CI], -29% to -20%) comparing acrylic with polymethylmethacrylate (PMMA) lenses; -9% (95% CI, -17% to -1%) comparing silicone with PMMA lenses; 14% (95% CI, -8% to 36%) comparing hydrogel with PMMA lenses; 4% (95% CI, -2% to 10%) comparing silicone with acrylic lenses; 19% (95% CI, 8% to 30%) comparing hydrogel with acrylic lenses; and 28% (95% CI, 10% to 46%) comparing hydrogel with silicone lenses. The pooled risk differences of PCO rates were -39% (95% CI, -47% to -31%) comparing acrylic with PMMA lenses; -14% (95% CI, -29% to 0%) comparing silicone with acrylic lenses; 56% (95% CI, 36% to 75%) comparing hydrogel with acrylic lenses; and 48% (95% CI, 31% to 64%) comparing hydrogel with silicone lenses. When comparing sharp with rounded-edge designs, pooled risk differences of capsulotomy rates were -47% (95% CI, -77% to -17%) in PMMA lenses, -22% (95% CI, -47% to 2%) in acrylic lenses, and -9% (95% CI, -17% to 0%) in silicone lenses; pooled risk differences of PCO rates were -28% (95% CI, -50% to -7%) in acrylic lenses and -37% (95% CI, -46% to -27%) in silicone lenses.

Conclusions: The rates of PCO and Nd:YAG laser capsulotomy may be influenced by different IOL biomaterials and optic edge designs. The lenses made by acrylic and silicone and those with sharp optic edges are superior in lowering the rates of PCO and laser capsulotomy.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Acrylic Resins
  • Biocompatible Materials*
  • Cataract / prevention & control*
  • Humans
  • Hydrogels
  • Laser Therapy / statistics & numerical data
  • Lens Capsule, Crystalline / pathology*
  • Lens Capsule, Crystalline / surgery
  • Lens Implantation, Intraocular
  • Lenses, Intraocular*
  • Phacoemulsification
  • Polymethyl Methacrylate
  • Postoperative Complications / prevention & control*
  • Prosthesis Design
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Silicone Elastomers

Substances

  • Acrylic Resins
  • Biocompatible Materials
  • Hydrogels
  • Silicone Elastomers
  • Polymethyl Methacrylate