Abstract
There is strong evidence that the IOL material is the factor having the greatest impact on posterior capsule opacification (PCO), anterior capsule opacification (ACO) development, and glistening formation after cataract surgery, even though there are other IOL features—such as haptic material and design and edge and optic design—that also have some influence. We reviewed the published literature describing the adverse events that are mainly related to the intraocular lens (IOL) material, such as PCO, ACO, and the subsequent capsule contraction, as well as glistening formation. The adverse events presented in this overview are the most common ones in clinical practice, and therefore, they are generally included in the clinical protocols for IOL evaluation.
Highlights
Cataract is at present the second cause of blindness worldwide after age-related macular degeneration; in Eastern and Central Europe, cataract is still the leading cause [1]
Recent studies [61,62,63] have shown that after 1 and 3 years of follow-up, the levels of posterior capsule opacification (PCO) were low for those eyes implanted with an intraocular lens (IOL) having a continuous sharp and square optic edge (Tecnis ZCB00, Agena MZ60BD (Alcon) SI-30NB (AMO)) and for those implanted with an IOL having an interrupted square optic edge (AcrySof SA60AT, Alcon) with no statistically significant differences between the two IOL models
Most of the studies showed lower PCO rates with hydrophobic than with hydrophilic and polymethyl methacrylate (PMMA) IOL materials due to the effects outlined by Linnola in the “Sandwich theory” [15]
Summary
Cataract is at present the second cause of blindness worldwide after age-related macular degeneration; in Eastern and Central Europe, cataract is still the leading cause [1]. Cataract surgery is constantly evolving and improving in terms of the lens material and designs. Cataract surgery is mainly performed using phacoemulsification and a foldable IOL, which is implanted through a small incision. IOL design and materials are constantly evolving fields, aiming for better refractive outcomes with minimal incision size and trying to minimize host-cell response, since it may cause posterior capsule opacification (PCO), anterior capsular opacification (ACO), and lens epithelial cell (LEC) proliferation. A detailed search strategy using terms related to cataract, intraocular lens, posterior capsular opacification, Nd:YAG laser, anterior capsule opacification, capsule contraction, and glistenings was prepared, to identify published literature reporting evidence that matched our research objectives. This review provides an overview of the currently available IOL materials and designs and discusses their effect upon PCO, ACO, capsule contraction, and glistening formation
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