Posterior capsular opacification requiring Nd:YAG capsulotomy after ENOVA GF3 hydrophobic monofocal IOL implantation

To evaluate the incidence, timing, and clinical characteristics of posterior capsule opacification (PCO) and Nd:YAG laser capsulotomy after uneventful cataract surgery with implantation of the ENOVA GF3 single-piece hydrophobic acrylic intraocular lens (IOL).

In this retrospective study, the medical records of patients with a minimum of 6 months follow-up who underwent uncomplicated phacoemulsification with in-the-bag implantation of the ENOVA GF3 hydrophobic monofocal IOL between January 2022 and December 2024 were reviewed. Standardized phacoemulsification was performed by a single surgeon, including posterior capsule polishing and verification of capsulorhexis-optic overlap. Postoperative best-corrected visual acuity (BCVA), refractive outcomes, and slit-lamp findings were recorded. Nd:YAG capsulotomy was performed when BCVA declined to 20/50 or worse or when central PCO impaired visual function or fundus visualization. The primary outcomes were the rates of PCO and Nd:YAG capsulotomy and the time intervals from surgery to PCO detection and capsulotomy.

A total of 151 eyes of 150 patients with mean age of 65.4±9.2 years were included. Significant improvement was observed in both uncorrected and corrected distance visual acuity at all postoperative visits (p 0.05). Postoperative refractive outcomes showed stability toward emmetropia with progressive reduction in spherical and cylindrical error (p 0.05). PCO developed in 5 eyes (3.3%). Of these, 3 cases (60%) were identified at postoperative month 1 and 2 cases (40%) at month 3. All PCO cases required Nd:YAG capsulotomy, performed at month 3 in 2 eyes (40%) and month 6 in 3 eyes (60%). No Nd:YAG-related complications were documented.

The ENOVA GF3 single-piece hydrophobic acrylic IOL demonstrated a low 1-year incidence of PCO (3.3%) requiring Nd:YAG capsulotomy, which may be attributed to its hydrophobic acrylic material, sharp posterior optic edge, and stable in-the-bag positioning. These findings support the favorable posterior capsular performance and optical stability of the ENOVA GF3 IOL. Longerterm, comparative, and prospective studies are warranted to further assess modifiable factors influencing PCO development.