Posterior Capsule Opacification in Silicone and Hydrophobic Acrylic Intraocular Lenses with Sharp-edge Optics Six Years After Surgery

PURPOSE. To compare posterior capsule opacification (PCO) between 2 three,piece intraocular tenses (IOLs) both with sharp,optic edges and open loop haptics, one made of silicone and the other made of hydrophobic acrylate, 6 years after surgery. DESIGN: Randomized, controlled, patient- and examiner-masked trial with intra-patient comparison. METHODS: One hundred and six eyes in 53 patients were included initially. Forty,four eyes of 22 patients with age related bilateral cataract were available for the 6 years follow-up. Each patient had standard cataract surgery and randomly received a silicone (CeeOn 911A; AMO, Santa Ana, California, USA) or hydrophobic acrylic (AcrySof MA60BM; Alcon, Fort Worth, Texas, USA) IOL in the first eye, the other type of IOL in the fellow eye. Follow-up examinations were at 1, 3, and 6 years after surgery. The intensity of posterior capsule opacification (PCO) was assessed using digital retro-illuminated photos and the "automated quantification of after-cataract" (AQUA) software. Neodymium-yttrium aluminum-garnet-laser capsulotomies (YAG-LC) performed were noted. RESULTS: Six years after surgery, the AQUA scores were 2.3 +/- 1.4 for the silicone and 3.8 +/- 2.0 for the acrylic IOLs (P = .0016). The acrylic 101, eyes also had a significant increase in AQUA score from the 3-year to the 6-year follow-up. YAG-LC were performed in 2 silicone and 6 acrylic IOLs (P = .01). CONCLUSIONS: An angulated three-piece hydrophobic acrylic IOL had more PCO 6 years after surgery than a silicone IOL of otherwise similar design. Apart from an optic material effect, differences in haptic design and the degree of optic edge sharpness may play a role. (Am J Ophthalmol 2009;147:683-690. (C) 2009 by Elsevier Inc. All rights reserved.)