ABSTRACT
PURPOSE: To evaluate the effect of 1-piece and 3-piece hydrophobic acrylic intraocular lenses (IOLs) on posterior capsule opacification (PCO) after cataract surgery. SETTING: Ophthalmology departments of 3 hospitals in the United Kingdom and Germany and the Department of Physics at a United Kingdom university. METHODS: A series of 131 patients having cataract surgery had implantation of an acrylic 1-piece (SA30AL) or an acrylic 3-piece (MA30BA) IOL (AcrySof, Alcon). Surgery was performed according to standardized protocol by a single surgeon at each hospital. Posterior capsule opacification was assessed using digital retroillumination photography. All images were analyzed at a single center according to a standard protocol. Data were analyzed 6 months and 1 year after surgery. RESULTS: There was no statistically significant difference in the percentage area of PCO between the 1-piece (mean 16.0% +/- 15.7% [SD]) and 3-piece (mean 13.6% +/- 19.8%) cohorts 6 months and 1 year after surgery (P =.0664). CONCLUSION: There was no evidence of a difference in the area of PCO after cataract surgery between 1-piece and 3-piece IOLs, which were otherwise matched for material and lens geometry.
Subject(s)
Cataract/etiology , Lens Capsule, Crystalline/pathology , Lenses, Intraocular/adverse effects , Postoperative Complications , Acrylic Resins , Aged , Biocompatible Materials , Follow-Up Studies , Humans , Lens Implantation, Intraocular , Phacoemulsification , Prosthesis DesignABSTRACT
PURPOSE: To investigate how posterior capsule opacification (PCO) affects visual function in pseudophakic eyes. METHODS: One hundred and six eyes that had undergone uncomplicated phacoemulsification were recruited sequentially. Patients with surgical complications or other ocular disease were excluded. PCO was assessed by a digital retroillumination camera using a software program based on the analysis of texture in the image, and the percentage area within the central 3-mm zone of the posterior capsule was calculated. Visual function assessment included Early Treatment Diabetic Retinopathy Study (ETDRS) high- and low-contrast visual acuity, contrast sensitivity with the Pelli-Robson and CSV-1000 grating charts, and forward light-scatter by the direct-compensation method (van den Berg). RESULTS: The percentage PCO required for decline in high-contrast ETDRS was 78%; for low-contrast acuity and Pelli-Robson, 46%; for CSV-1000 contrast sensitivity, 38% to 51%; and for forward light-scatter, less than 1% PCO. CONCLUSIONS: Central PCO affects psychophysical test results with differing degrees of sensitivity. Forward light-scatter is the most sensitive, followed by contrast sensitivity and visual acuity.
Subject(s)
Cataract/physiopathology , Contrast Sensitivity/physiology , Lens Capsule, Crystalline/physiopathology , Postoperative Complications , Vision Disorders/physiopathology , Visual Acuity/physiology , Aged , Aged, 80 and over , Female , Humans , Lens Implantation, Intraocular , Light , Male , Middle Aged , Phacoemulsification , Pseudophakia/physiopathology , Psychophysics , Scattering, RadiationABSTRACT
PURPOSE: To investigate the value of early retroillumination imaging of the posterior capsule in predicting the eventual development of posterior capsule opacification (PCO). SETTING: Ophthalmology Department, St. Thomas' Hospital, and Department of Physics, King's College, London, United Kingdom. METHODS: All patients with retroillumination images of the posterior capsule taken 6 months and 2 years after uneventful phacoemulsification with in-the-bag intraocular lens (IOL) implantation were selected. The images were taken using the same hardware and analyzed with the same software to calculate the percentage area of the posterior capsule covered by lens epithelial cells. The percentage area of PCO with all IOL types 6 months postoperatively was correlated with that at 2 years. RESULTS: One hundred forty patients had analyzable images at 6 months and 2 years. Of these, 63 had a poly(methyl methacrylate) (PMMA) IOL (Pharmacia 812A or Storz P497UV), 33 an acrylic (Alcon AcrySof MA30 or SA30), 22 a silicone (Allergan SI-30), and 22 a hydrophilic acrylic (Bausch & Lomb Hydroview H60). The correlation of the percentage area of PCO at 6 months with that at 2 years resulted in an r value of 0.71 (P <.0001) in the entire group. The r value was 0.48 in the PMMA group and 0.86 in the foldable IOL group (P <.0001) (r value: AcrySof, 0.66; silicone, 0.82; Hydroview, 0.75). CONCLUSIONS: Retroillumination imaging of the posterior capsule 6 months after cataract surgery predicted the PCO outcome at 2 years in eyes with foldable IOLs.
