Influence of optic edge design and anterior capsule polishing on posterior capsule fibrosis

Abstract

Purpose: To evaluate the role of posterior optic edge design and the effect of anterior capsule polishing on peripheral fibrotic posterior capsule opacification (PCO). Setting: Department of Ophthalmology, University of Vienna, Vienna, Austria. Methods: This randomized prospective study comprised 144 eyes of 72 patients with bilateral age-related cataract. Each patient had standardized cataract surgery in both eyes by the same surgeon. Group 1 (46 patients) received a round-edged hydrophobic acrylic IOL (AMO Sensar ® AR40) in 1 eye and a sharp-edged hydrophobic acrylic IOL (AMO Sensar ® OptiEdge AR40e) in the other eye. Group 2 (26 patients) received a silicone IOL (Pharmacia CeeOn ® 911A) with a truncated optic in both eyes. In this group, the anterior capsule was extensively polished in 1 eye and was left unpolished in the other eye. Digital slitlamp photographs were taken 1 year postoperatively using a standardized photographic technique for fibrotic PCO. The intensity of PCO was subjectively graded (score 0 to 4) by 2 masked examiners. Results: Subjective PCO scores correlated well between the 2 examiners ( r = 0.88). In Group 1, the mean PCO score was 0.26 for the OptiEdge AR40e IOL and 0.90 for the AR40 IOL ( P<.01). In Group 2, the mean PCO score was 0.24 in eyes with a polished capsule and 0.17 in eyes in which the capsule was not polished ( P = .31). Conclusions: The sharp-edged OptiEdge AR40e IOL led to significantly less peripheral fibrotic PCO 1 year postoperatively than the round-edged AR40 IOL. In eyes with the sharp-edged silicone 911A IOL, anterior capsule polishing caused no significant difference in fibrotic PCO.