Posterior capsule opacification after cataract surgery in children over five years of age with square-edge hydrophobic versus hydrophilic acrylic intraocular lenses: a prospective randomized study

OBJECTIVE: To compare the effects of hydrophobic and hydrophilic materials in square-edged acrylic intraocular lenses (IOLs) on the development of posterior capsule opacification (PCO) after pediatric cataract surgery. METHODS: Patients were randomly assigned to group 1 (hydrophobic acrylic square-edged IOLs; 13 eyes) or group 2 (hydrophilic acrylic square-edged IOLs; 13 eyes). The study evaluated PCO rates using Evaluation of Posterior Capsule Opacification (EPCO) 2000 software at one, three, six and 12 months postoperatively. Postoperative measurements also included corrected distance visual acuity (CDVA), neodymium:yttrium‐aluminum‐garnet (Nd:YAG) capsulotomy and postoperative complications other than PCO. RESULTS: Both groups had significant increases in PCO rates after one year. Comparison of the groups showed no significant differences in the EPCO scores at three (group 1, 0.007±0.016 vs group 2, 0.008±0.014; p=0.830), six (group 1, 0.062±0.103 vs group 2, 0.021±0.023; p=0.184), or twelve months postoperatively (group 1, 0.200±0.193 vs group 2, 0.192±0.138; p=0.902). We also found no significant group differences regarding the change (delta, Δ) in EPCO scores between three and six months (group 1, 0.055±0.09 vs group 2, 0.013±0.02; p=0.113) or between six and twelve months postoperatively (group 1, 0.139±0.14 vs group 2, 0.171±0.14; p=0.567). Twenty-three percent of patients required Nd:YAG capsulotomy at the twelve-month visit. CONCLUSIONS: No differences in PCO rates were found between hydrophobic and hydrophilic acrylic square-edged IOLs in children between five and twelve years of age at one year of follow-up.

Toxic Anterior Segment Syndrome Following Cataract Surgery

PURPOSE: To report clinical and laboratory findings of toxic anterior segment syndrome (TASS) in seven patients following cataract surgery with intraocular lens (IOL) implantation. METHODS: The medical records of seven patients who underwent cataract surgery associated with postoperative decreased visual acuity, ocular pain, anterior chamber inflammation and corneal edema between Feb 2007 and Nov 2009 were retrospectively reviewed. RESULTS: All patients were over 60 years of age, four patients had diabetes and four patients had cardiovascular disease. Five patients had received hydrophilic IOL, and six patients underwent surgery later in order. All seven patients presented with increased anterior segment inflammation, acute decreased visual acuity, and severe corneal edema an average of 10.4 days (range 1 to 15 days) after surgery. Treatment of the seven patients included intensive topical and oral steroids, and improvement was noted in all patients. CONCLUSIONS: The incidence of TASS after cataract surgery was 0.8%, and was significantly higher in cases of hydrophilic IOL insertion (5 of 284 cases, 1.76%) compared to cases of hydrophobic IOL insertion (2 of 581 cases, 0.34%) (p = 0.04). Five of the seven cases presented with TASS at postoperative day 14. Inflammation improved in all patients with steroid treatment.