Comparison of monofocal intraocular lenses for uncomplicated age-related cataract

Abstract

Background: The Health Technology Assessment Unit at the Alberta Heritage Foundation for Medical Research (AHFMR) has prepared a report on the safety, efficacy and effectiveness of foldable monofocal intraocular lenses (IOLs) (silicone and acrylic) over polymethylmethacrylate (PMMA) IOLs for the treatment of uncomplicated age-related cataract. In this article the author describes the methods and findings of the AHFMR report.Methods: A systematic literature search of 10 electronic databases (1991 to May 1999) was conducted for the AHFMR assessment. The quality of the studies was analysed by means of explicit criteria.Results: Eight studies with a follow-up time of at least 6 months were located that compared the three types of IOL. Decentration and tilt were not an issue for any of the IOLs evaluated. The posterior capsule opacification and capsulotomy rates were lower among patients with the soft acrylic lens over a follow-up period of 2 to 3 years than among patients with the PMMA or silicone lens.Interpretation: On the basis of weak scientific evidence, foldable acrylic IOLs appear to offer greater short- to medium-term (3 years) benefits than PMMA and silicone lenses in regard to biocompatibility, anterior capsular stability and risk of posterior capsule opacification. There appears to be little good-quality information to guide ophthalmologists, consumers and provincial health care funders in their choice of the most appropriate type of IOL.