Effect of anterior capsule polishing on fibrotic capsule opacification: Three-year results

Abstract

Purpose: To evaluate the long-term effect of anterior capsule polishing on anterior capsule opacification (ACO) and peripheral fibrotic posterior capsule opacification (PCO). Setting: Department of Ophthalmology, Medical University of Vienna, Vienna, Austria. Methods: This randomized double-blind study comprised 104 eyes of 52 patients with bilateral age-related cataract. All patients received round-edged intraocular lenses (IOLs); 26 received an SI-40 IOL (Advanced Medical Optics Inc.) in both eyes, and 26 received a Silens6 IOL (Domilens) in both eyes. Both IOLs consist of different silicone material and have different haptic angulation. The SI-40 IOL has 13.0 mm open-loop poly(methyl methacrylate) (PMMA) haptics angulated by 10 degrees. The Silens6 IOL has 12.5 mm open-loop PMMA haptics with no angulation. In 1 eye, the anterior capsule was extensively polished. The anterior capsule was left unpolished in the contralateral eye, which acted as a control. Digital slitlamp photographs of the ACO and fibrotic PCO were taken with a standardized technique for 3 years postoperatively. The intensity of ACO was measured objectively (score 0% to 100%) using Adobe Photoshop software. Fibrotic PCO was graded subjectively (score 0 to 4). Results: The mean ACO was 17% in the polished eyes and 26% in the control eyes ( P = .0001). The mean fibrotic PCO score was 0.5 and 1.0, respectively ( P = .0007). The mean ACO was 15% in the polished SI-40 eyes and 26% in the control SI-40 eyes ( P = .01). It was 19% in the polished Silens6 eyes and 26% in the control Silens6 eyes ( P = .003). The mean fibrotic PCO score was 0.4 in the polished SI-40 eyes and 1.1 in the control SI-40 eyes ( P = .0006). It was 0.6 in the polished Silens6 eyes and 0.9 in the control Silens6 eyes ( P = .08). Conclusions: Three years after surgery, eyes in which the anterior capsule was extensively polished had less ACO and fibrotic PCO with both round-edged silicone IOLs. In eyes with Silens6 IOLs, however, the reduction in fibrotic PCO was not significant.