Abstract
Purpose: To compare the change in size of continuous curvilinear capsulorhexis (CCC) used for implantation of three types of intraocular lenses (IOLs) and to determine the role of postoperative inflammation, initial CCC dimension, haptic design, and optic material.Setting: Hôpital Ophtalmique Universitaire Jules Gonin, Lausanne, Switzerland.Method: Twenty-nine three-piece, silicone/poly(methyl methacrylate) (PMMA) IOLs (lovision 127), 26 one-piece PMMA IOLs (Pharmacia 812A), and 27 plate-haptic silicone IOLs (Staar AA4203) were implanted in the capsular bag after phacoemulsification. Photographs of the CCCs taken 1 day and 6 months after surgery were scanned and digitized on a computer. Using different software, the surface of the CCC was measured and the 6 month change evaluated. Flare, measured the day before surgery and postoperatively at days 1, 7, 30, and 180, was integrated to obtain a global estimate of inflammation during the 180 day follow-up.Results: The CCCs used with three-piece, silicone/PMMA IOLs showed little changes in surface, with a mean enlargement of +0.57 mm2 ± 1.15 (SD) (+3.5%). The CCCs used with the one-piece PMMA IOLs had a slight tendency to constrict, with a mean surface decrease of −0.59 ± 2.16 mm2 (−4.3%). The CCCs used with plate-haptic silicone IOLs showed a marked and statistically significant constriction, with a mean decrease of −2.55 ± 3.51 mm2 (−14.4%). The change in CCC size was not associated with the integrated flare, and no correlation was found between the initial CCC size and the magnitude of change. There was no statistically significant difference in CCC change between the PMMA optic IOL (Pharmacia) and silicone optic IOL (lovision and Staar) groups. The CCC in the plate-haptic IOL (Staar) group showed a significant (P < .0002) constriction when compared with that in the loop-haptic IOL (Pharmacia and lovision) group.Conclusion: The IOLs' haptic design seemed to play a major role in the evolution of the CCC. The CCC constriction seen with the Staar IOLs was related to their plate haptics.
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