Clinical consequences of acrylic intraocular lens material and design: Nd:YAG-laser capsulotomy rates in 3 x 300 eyes 5 years after phacoemulsification

Br J Ophthalmol. 2010 Apr;94(4):450-5. doi: 10.1136/bjo.2009.166181. Epub 2009 Oct 14.

Abstract

Background/aims: To investigate the incidence of Nd:YAG-laser treatment for posterior capsular opacification (PCO) over a period of 5 years from phacoemulsification in an unselected population, comparing outcomes for three acrylic intraocular lenses (IOLs).

Methods: Retrospective longitudinal cohort study comprising 900 eyes. Three subgroups of 300 eyes, receiving the AR40, AR40e (Abbott Medical Optics, Santa Ana, California), or BL27 (Bausch & Lomb, Rochester, New York) IOL respectively, were compared. Data on patient age, gender, IOL type, dates of cataract surgery, Nd:YAG-laser treatment and/or death, and visual acuities before/after cataract surgery/Nd:YAG-laser treatment were collected from five sources: cataract operation register, patient administration system, quality control system for cataract operations, Nd:YAG-laser treatment register and clinical patient records.

Results: 216 eyes (24%) received Nd:YAG-laser treatment over a 5-year period. Statistically significant differences (p<0.001, chi(2) test) were found between treatment rates for the three IOLs: AR40 73 eyes (24%), BL27 91 eyes (30%) and AR40e 52 eyes (17%). Eyes of patients who died during the follow-up period had fewer treatments (23/266, 8.6%) than eyes of patients living (193/634, 30%) at the end of the follow-up period.

Conclusion: In comparison with a hydrophobic acrylic IOL with sharp posterior optic edge, a hydrophilic acrylic IOL was associated with almost twice the number of Nd:YAG-laser treatments over the 5-year period. The results are useful for discussing the economic long-term consequences of choosing an IOL with a design that makes PCO development more or less likely. Caution is advised when applying data from post-mortem PCO studies on living populations.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acrylic Resins
  • Adult
  • Aged
  • Aged, 80 and over
  • Cataract / etiology*
  • Cataract / physiopathology
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Laser Therapy / methods*
  • Lenses, Intraocular / standards*
  • Male
  • Middle Aged
  • Phacoemulsification*
  • Posterior Capsule of the Lens / surgery*
  • Postoperative Complications / etiology*
  • Postoperative Complications / physiopathology
  • Prosthesis Design
  • Reoperation
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity / physiology

Substances

  • Acrylic Resins