Prospective evaluation of posterior capsule opacification in myopic eyes 4 years after implantation of a single-piece acrylic IOL

PURPOSE: To determine whether axial myopia affects posterior capsule opacification (PCO) in eyes with high myopia (axial length [AL] >= 26.00 mm) 4 years after implantation of an AcrySof single-piece intraocular lens (IOL). SETTING: Clinical practice, Ahmedabad, India. METHODS: In a prospective masked trial, consecutive eyes with high axial myopia (myopia group) and age-matched eyes with a normal AL (21.00 to 23.99 mm) (control group) had phacoemulsification and in-the-bag IOL implantation. Postoperatively, PCO was documented by standardized digital retroillumination images. The PCO area behind the IOL optic was scored (scale 0% to 100%) using the POCO software system. The presence of PCO within the central 3.0 mm of the optic was assessed with the Evaluation of Posterior Capsule Opacification software system. The incidence of neodymium:YAG (Nd:YAG) capsulotomy was determined. RESULTS: The median PCO in the myopia group and control group, respectively, was 3.2% and 5.6% at 1 month (P = .2), 2.2% and 1.6% at 12 months (P = .079), 7.0% and 2.3% at 24 months (P = .079), 3.7% and 3.6% at 36 months (P = .78), and 10.0% and 2.3% at 48 months (P = .61). By 4 years, PCO had encroached onto the central 3.0 mm of the optic in 38% in the myopia group and 20% in the control group (P = .04). One eye (2%) in each group had an Nd:YAG capsulotomy, at 3.2 years and 3.9 years, respectively. CONCLUSION: Axial myopia did not significantly increase the area or incidence of PCO at 4 years.