Optic edge design as long-term factor for posterior capsular opacification rates.

Area of Science:

• Ophthalmology
• Biomaterials Science

Background:

• Posterior capsular opacification (PCO) is a common complication after cataract surgery.
• The design of intraocular lenses (IOLs), specifically the optic edge, may influence PCO development.

Purpose of the Study:

• To compare PCO incidence between highly refractive silicone and hydrophobic acrylic foldable IOLs with sharp versus round edge designs.
• To evaluate PCO development 3 years post-implantation in patients undergoing bilateral cataract surgery.

Main Methods:

• A prospective, randomized, multicenter clinical trial involving 288 patients.
• Intraindividual comparison of sharp-edged silicone IOLs (CeeOn) against round-edged silicone (PhacoFlex) or sharp-edged acrylic (AcrySof) IOLs.
• Morphological evaluation of PCO using the EPCO system and Nd:YAG laser treatment rates at 3 years.

Main Results:

• The cumulative incidence of Nd:YAG laser capsulotomy was similar for sharp-edged silicone and acrylic IOLs (2.1%).
• Sharp-edged silicone IOLs showed significantly less PCO compared to round-edged silicone IOLs (5.7% vs. 17.0%).
• EPCO scores at 3 years were lower for sharp-edged IOLs regardless of material.

Conclusions:

• Modern foldable IOLs exhibit a low incidence of PCO at 3 years.
• Sharp optic edge designs are associated with reduced PCO, irrespective of the IOL material (silicone or acrylic).