Posterior capsular opacification in phacotrabeculectomy: A long-term comparative study of silicone versus acrylic intraocular lens

Abstract

Purpose To investigate the long-term outcomes of silicone versus acrylic intraocular lens (IOL) implantation in phacotrabeculectomy (PT) with special emphasis on posterior capsular opacification. Design Long-term follow-up on prior 1-year prospective, randomized study. Participants A total of 200 eyes of 200 consecutive primary open-angle glaucoma patients who had undergone primary PT with capsular bag implantation of either a silicone IOL (102 eyes) or an acrylic IOL (98 eyes) according to the initial short-term prospective, randomized study protocol. Intervention The study eyes underwent primary trabeculectomy, phacoemulsification, and posterior chamber IOL implantation. Adjunctive mitomycin C was used selectively, primarily in patients with one or more risk factors for filtration failure. Main outcome measures Incidence of posterior capsular opacification (PCO), best-corrected visual acuity (BCVA), intraocular pressure (IOP), number of pressure-lowering medications, and filtration success rates, defined as maintenance of target IOP while on one (criteria 1) or zero (criteria 2) pressure-lowering medications without further surgical intervention. Results At 3-year follow-up, the PCO rate and BCVA did not differ significantly between the two groups ( P > 0.05 for both). In addition, there were no significant differences in IOP, number of medications, and filtration success rate between the two groups ( P > 0.05 for each). Conclusions There were no significant long-term differences between the silicone and acrylic IOL groups in PCO, BCVA, IOP, number of medications, and success of filtration surgery after PT. Both groups attained significant improvement in BCVA and IOP control after surgery.