Long-term Posterior Capsule Opacification Reduction with Square-Edge Polymethylmethacrylate Intraocular Lens:...

Area of Science:

• Ophthalmology
• Biomaterials Science
• Medical Optics

Background:

• Posterior capsule opacification (PCO) is a common complication after cataract surgery, potentially requiring neodymium-doped yttrium aluminium garnet (Nd:YAG) capsulotomy.
• Intraocular lens (IOL) design, particularly edge geometry, may influence PCO development.

Purpose of the Study:

• To compare the long-term PCO and Nd:YAG capsulotomy rates of a square-edge (SE) polymethylmethacrylate (PMMA) IOL with round-edge (RE) PMMA IOL and SE hydrophobic acrylic IOL (SE-Acrylic).

Main Methods:

• A prospective, randomized, controlled fellow eye study involving 94 patients undergoing bilateral cataract surgery.
• Patients received SE-PMMA IOL in one eye and either RE-PMMA IOL or SE-Acrylic IOL in the fellow eye.
• Objective PCO grading using EPCO software from retroillumination photographs annually for 5 years and at year 9.

Main Results:

• SE-PMMA IOLs showed significantly lower PCO scores than RE-PMMA IOLs at all follow-ups (P < 0.05).
• SE-PMMA IOLs also demonstrated lower PCO scores than SE-Acrylic IOLs, except at 1 and 3 years.
• Nine-year Nd:YAG capsulotomy rates were 2% for SE-PMMA vs. 37% for RE-PMMA (P < 0.001) and 4% for SE-PMMA vs. 10% for SE-Acrylic (P = 0.435).

Conclusions:

• A simple SE modification of PMMA IOLs significantly reduces PCO and Nd:YAG capsulotomy rates compared to RE PMMA IOLs.
• This cost-effective IOL design modification offers a potential solution for reducing secondary membrane formation, particularly in developing countries.