Rate Of Posterior Capsule Opacification Research Articles

Intraindividual comparison of capsule behavior of 2 hydrophobic acrylic intraocular lenses during a 5-year follow-up

To evaluate and compare the 5-year postoperative anterior (ACO) and posterior capsule opacification (PCO), the occurrence of glistenings, and the level of anterior capsule retraction after implantation of 2 designs of 1-piece hydrophobic acrylic IOLs. Hospital St. John, Vienna, Austria. Randomized controlled prospective case series. Patients had an Acrysof SA60AT IOL (Group A) implantedin 1 eye and a Tecnis ZCB00 IOL (Group B) implanted in the fellow eye. At 1, 3, and 5years, the PCO level was evaluated with the Evaluation of Posterior Capsule Opacification software. The level of ACO and capsule retraction was graded subjectively. Glistenings were scored as present or not present. Fifty eyes of 25 patients were evaluated after 5years. No significant differences in PCO scores were found between the 2 groups at all follow-up visits (1year: 0.06±0.12 [SD] versus 0.07±0.13, P=.35; 3years: 0.23±0.36 versus 0.22±0.32, P=.66; 5years: 0.36±0.41 versus 0.36±0.54, P=.98). A significant increase in PCO score was found between 3 and 5years (P<.01). Anterior capsule opacification was present in Group A and Group B in 18.0% and 2.7% of eyes (P=.03), in 92.0% and 24.0% of eyes, and in 100% and 52% of eyes (P<.01) at 1, 3, and 5years, respectively. Glistenings (5years 100%) were observed in Group A. Both IOLs had a comparable PCO rate 5years after surgery, although more ACO and retraction as well as glistenings were observed in Group A.

Long-term Posterior Capsule Opacification Reduction with Square-Edge Polymethylmethacrylate Intraocular Lens: Randomized Controlled Study

To objectively assess the long-term posterior capsule opacification (PCO) and neodymium-doped yttrium aluminium garnet (Nd:YAG) capsulotomy rate of a square-edge (SE) polymethylmethacrylate (PMMA) intraocular lens (IOL) modification in comparison with a round-edge (RE) PMMA IOL or an SE hydrophobic acrylic IOL (SE-Acrylic). Prospective, randomized, controlled fellow eye clinical study. Ninety-four patients scheduled for bilateral phacoemulsification had an SE-PMMA IOL implanted in 1 eye. An RE-PMMA IOL was implanted in the fellow eye in 46 patients (group A), and an SE-Acrylic IOL was implanted in the fellow eye in 48 patients (group B). Randomization was used to determine group assignment and which IOL was implanted in the first eye to undergo surgery. Evaluation of Posterior Capsule Opacification (EPCO) image analysis software was used to objectively grade PCO density from standardized, high-resolution retroillumination photographs obtained annually for the first 5 postoperative years and at year9. The PCO scores and Nd:YAG capsulotomy rate. Nine-year follow-up was achieved by 72% from group A and 63% from group B. In group A, the mean PCO score was significantly lower in the SE-PMMA IOL eyes compared with the contralateral RE-PMMA eyes at all follow-up visits (P < 0.05). In group B, the mean PCO score was statistically lower in the SE-PMMA IOL eyes compared with the contralateral SE-Acrylic IOL eyes at all but the 1- and 3-year follow-up visits. Nine-year Nd:YAG capsulotomy rates were 2% for SE-PMMA IOLs versus 37% for RE-PMMA IOLs in group A (P < 0.001), and 4% for SE-PMMA IOLs versus 10% for SE-Acrylic IOLs in group B (P= 0.435). The RE-PMMA PCO rate did not plateau and continued to increase throughout the 9-year study period. This prospective, 9-year fellow eye comparison study suggests that an inexpensive PMMA IOL design modification-a squared optic edge-could significantly reduce the burden of vision-impairing secondary membrane in developing countries.

Effect of Anterior Capsule Polishing on the Need for Laser Capsulotomy

Purpose: To determine the effect of anterior capsule polishing (APC) on the rate of posterior capsule opacification (PCO) as assessed by the need for laser posterior capsulotomy. Setting: University-based clinical practice, Jules Stein Eye Institute, Los Angles, California, USA. Methods: This study involved a retrospective review of eyes that underwent phacoemulsification and intraocular lens implantation between September 1991 and June 1999. Lens epithelial cells in the 763 study eyes were mechanically debrided or polished from the inside surface of the anterior capsules using a pair of Shepherd-Rentsch (Morning STAAR Inc.) capsule polishers. The 484 control eyes that had surgery earlier in the series were not polished. The rate of laser capsulotomy in the ACP and the non-ACP groups was compared using a Kaplan-Meier survival analysis. Multivariate regression was performed to determine if variables other than ACP influenced the need for laser posterior capsulotomy. Results: We identified 763 eyes that had ACP and 484 that did not. At the 24-month follow-up interval, 26.6% of the eyes in the ACP group had received a capsulotomy versus 19.50% in the non-APC. Next, a separate study was done using only one eye per patient, taking the patient as the unit of analysis. Again the capsulotomy rate was higher in the ACP group compared to the non-ACP (1.02 per 100 person-months of follow-up vs. 0.74 per 100 person-months of follow-up). Finally, a third Kaplan-Meier analysis was done on 52 patients that had one eye treated with the ACP procedure and the other eye with the non-ACP procedure. Although the log-rank test showed the statistical significant of this analysis to be borderline, the results again favored the non-ACP group with a lower capsulotomy rate. Multivariate analysis showed very similar results to the above univariate studies. The mean time to capsulotomy was 46 months for the polished group and 70 months for the unpolished group. The severity of cataract (p = 0.46) and the type of haptics (p = 0.86) did not influence the rate of capsulotomy. Plate haptic IOLS had a higher rate of capsulotomy than loop haptic IOLS (p = 0.001). Conclusions: Polishing of the anterior capsule with Shepherd-Rentsch polishers may unexpectedly increase the rate of posterior capsule opacification in eyes with round-edge silicone lenses.

Posterior Capsule Opacification and Nd-YAG rates evaluation in a large series of pseudophakic cases

To evaluate the influence of Intraocular Lens (IOL) material and design on Posterior Capsule Opacification (PCO) and Neodymium-YAG (Nd-YAG) rates in eyes implanted with different Posterior Chamber Intraocular Lenses (PC IOLs) designs at the end of uncomplicated cataract surgeries. Oculus Eye Clinic, Bucharest, Romania. Retrospective, observational study. This study comprised 4805 eyes operated for cataract in 2012 and 2013 with a post-operative average follow up of 40 ± 6,15 months (27-54 months). The PCO and Nd-YAG rates were recorded and compared among different IOL materials and designs and among different pathology groups. From 4805 IOLs implanted, 2560 (53,27%) were hydrophilic and 2245 (45,73%) hydrophobic, 2937 (61%) were aspherical and 1868 (39%) spherical. We found statistical significant differences in the PCO and Nd-YAG rates between hydrophilic (18% and 14% respectively) and hydrophobic lenses (4% and 2% respectively) (p<0.0001). There were also statistically significant differences in the sub-group of hydrophilic aspheric IOLs, finding lower PCO and Nd:YAG rates with the C-loop haptics configuration (12,6% and 3,3% respectively) compared with the broad optic/ haptic junction (29,75% and 24,73% respectively) (p<0.001). No statistically significant differences on PCO and Nd:YAG rates were found for the different associated pathologies (p>0.05). Hydrophilic lenses showed statistically higher PCO and Nd:YAG rates than hydrophobic lenses. In contrast, the optic asphericity and the associated pathologies had no influence on the PCO and Nd:YAG rates. IOL design and material seem to be the main characteristics influencing PCO and Nd-YAG rates. LECs = lens epithelial cells.

Surgical indications, outcomes, and complications with the use of a modified capsular tension ring during cataract surgery

To determine the surgical indications, outcomes, and complications with the use of modified capsular tension rings (CTRs) during cataract surgery. Ivey Eye Institute, Western University, London, Ontario, Canada. Systematic review. A systematic review of databases was conducted for studies related to the use of modified CTRs during cataract surgery that were published between 1992 and 2015. Primary research papers on human participants published in English were screened. The surgical indications, outcomes, and complications of modified CTR use during cataract surgery were compiled and analyzed. The search identified 6035 records from published and gray literature. After screening, 10 studies involving 320 eyes were included in the systematic review. The most common surgical indications for modified CTR use were Marfan syndrome (40.3%), idiopathic zonular insufficiency (27.2%), and previous ocular trauma (22.8%). The weighted average of indicated zonular insufficiency was 173 degrees, with 75.4% of eyes achieving visual acuity better than 20/40 postoperatively. The use of modified CTRs resulted in a reduction in intraocular lens (IOL) decentration and tilt. Vitrectomy during surgery was required in 19.8% of eyes. The rate of posterior capsule opacification (PCO) was 41.1%. Intraocular pressure (IOP) elevation, suture breakage, and uveitis were the most common postoperative complications. The use of modified CTRs during cataract surgery was associated with causes of large and progressive zonular insufficiency. Use of the CTR produced good postoperative visual outcome and reduced IOL decentration and/or tilt. The most common complications were PCO, IOP elevation, and suture breakage. None of the authors has a financial or proprietary interest in any material or method mentioned.

Influence of Intraocular Lens Material and Eye Axial Length on Posterior Capsule Opacification Dynamic Rate and Frequency

Purpose: To evaluate posterior capsule opacification (PCO) formation dynamic rate and frequency in artificial eyes with myopia in different terms after cataract extraction and it’s relation with IOL material. Patients and methods. An evaluation of PCO formation dynamic rate and frequency was done by using a retrospective analysis of YAG-laser assist posterior capsule dissections in different terms after cataract extraction on 45640 eyes of 43520 patients with emmetropia and myopia without concomitant pathology. The mean patient’s age was 73±7 years and the least follow-up after hacoemulsification was 5 years. All eyes were divided on two groups. The first group included 25339 eyes where a hydrophilic IOL was implanted; the second group included 20301 eyes where a hydrophobic IOL was implanted. Results. At the first group the YAG-laser assist posterior capsule dissection was done on 2128 (8,4%) eyes. It was shown a proportional influence of axial length on PCO frequency but more rapidly the PCO rate increased between 26 to 28 mm and then this parameter had stabilization. The PCO dynamic rate had a normal statistical corresponding in the group with maximum at third postoperative year. At the second group YAG-laser assist posterior capsule dissection was done on 244 (1,2%) eyes. It was shown a proportional influence of axial length on PCO frequency too. But increasing of axial length more than 28 mm increased PCO rate correspondingly that differ the second group from the first. The PCO dynamic rate had an inversely proportional character in the group. Comparing the PCO frequency in both groups showed that hydrophobic material has less PCO rate with any axial length and every time of follow-up. Conclusion. An IOL’s material plays an important role in PCO formation and PCO formation dynamic rate. Hydrophobic material has a statistically significant less PCO frequency through five-year follow-up in eyes with myopia and emmetropia. The PCO dynamic rate strongly differ between groups with a normal statistical corresponding in group 1 and inversely proportional in group 2.

Square-edge intraocular lens versus conventional round-edge intraocular lens in prevention of posterior capsule opacification: A randomized clinical trial

Aim: To determine whether square-edge polymethyl methacrylate (PMMA) intraocular lens (IOL) is superior in preventing clinically significant posterior capsule opacification (PCO) and better visual outcome when compared with round-edge PMMA IOL in manual small-incision cataract surgery (MSICS). Settings and Design: Tertiary care hospital-based randomized controlled clinical trial. Materials and Methods: A randomized clinical trial of 1 year in which 128 patients were randomized into two groups to receive round-edge IOLs (Group A) or square-edge IOLs (Group B) after MSICS and followed up for 10 months; during follow-up, the best corrected visual acuity, grades, and type of PCO were documented. Statistical Analysis Used: Data analysis was done using chi-square test. Results: Out of 128 patients, the incidence of PCO was 83.6%, out of which 85.9% were in Group A and 81.2% were in Group B. Visual outcome was better in Group B, which was statistically significant (0.003). The fibrous type of PCO was the commonest type seen in the study irrespective of the group. There was less incidence of PCO in capsulorrhexis (with relieving incisions) and complete cortical cleanup cases. Difference in neodymium-doped yttrium aluminum garnet; Nd:Y3Al5O12 (Nd:YAG) laser capsulotomy rates were not statistically significant between the two groups (P = 0.784). Conclusions: This study showed that square edge PMMA IOLs had less clinically significant PCO rates and better visual outcome when compared to round-edge PMMA IOLs.

Posterior capsule opacification in pediatric eyes with and without traumatic cataract

To compare the rate of visually significant posterior capsule opacification (PCO) in pediatric eyes with and without traumatic cataract. Storm Eye Institute, Charleston, South Carolina, USA. Retrospective case control study. Eyes operated on for traumatic cataract and having in-the-bag single-piece hydrophobic intraocular lens (IOL) implantation were identified. The control group of eyes operated on for nontraumatic cataract was matched with reference to age, management of the posterior capsule, type of IOL, and follow-up duration. Data from 58 eyes were studied. Age at surgery was comparable between the study group and the control group (7.3 versus 7.8 years) (P = .7). The rate of PCO was statistically significantly different between the 2 groups (12/29 eyes versus 2/29 eyes) (P = .002). This difference was more marked for those with intact posterior capsules (9/12 eyes [75%] and 1/12 eyes [8%] (P = .001) compared with eyes with primary posterior capsulectomy and vitrectomy (3/17 [18%] and 1/17 [6%] (P = .6). For eyes with intact posterior capsules, the duration between cataract surgery and intervention for PCO was 4 to 15 months in the traumatic cataract group; 1 eye in the nontraumatic cataract group required intervention 20 months after surgery. Eyes with traumatic cataract were more likely to develop PCO than eyes without traumatic cataract. The results also suggest that PCO develops faster in eyes with traumatic cataract. Primary posterior capsulectomy and vitrectomy should be considered for children having traumatic cataract surgery, irrespective of age at the time of surgery. Neither author has a financial or proprietary interest in any material or method mentioned.

Effect of four different intraocular lenses on posterior capsule opacification.

To evaluate the impact of 4 different intraocular lenses (IOLs) on posterior capsule opacification (PCO) by comparing the neodymium: yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy rates. This retrospective study included 4970 eyes of 4013 cataract patients who underwent phacoemulsification and IOL implantation between January 2000 and January 2008 by the same surgeon at one clinic. Four different IOLs were assessed. The outcome parameter was the incidence of Nd:YAG laser posterior capsulotomies. An Nd:YAG laser posterior capsulotomy was performed in 153 (3.07%) of the 4970 eyes. The mean follow-up time was 84mo for all of the IOL groups. The percentage of eyes developing PCO was significantly greater for the acrylic hydrophilic IOLs than for the hydrophobic IOLs, although eyes with acrylic hydrophilic IOLs did not require Nd:YAG laser capsulotomy as soon as eyes with acrylic hydrophobic IOLs. There was no difference between the long-term PCO rates when 1- and 3-piece acrylic hydrophobic IOLs were compared or when IOLs made of the same material but with different haptic angles were compared. In this study, eyes with acrylic hydrophilic IOLs were more likely to develop PCO than those with acrylic hydrophobic IOLs. The lens design (1-piece versus 3-piece and varying haptic angles) did not affect the PCO rate.

The effect of femtosecond laser capsulotomy on the development of posterior capsule opacification.

To evaluate and compare the effects of femtosecond laser-assisted anterior capsulotomy and manual anterior capsulorhexis on posterior capsule opacification (PCO) development. Femtosecond laser-assisted anterior capsulotomy was performed in 40 eyes of 40 patients (FS group) and manual anterior capsulorhexis was performed in 39 eyes of 39 patients (CCC group). An AcrySof one-piece hydrophobic acrylic intraocular lens (Alcon Laboratories, Inc., Fort Worth, TX) was implanted in all eyes. The PCO level was measured using Open-Access Systematic Capsule Assessment (OSCA) software 18 to 26 months after surgery. Postoperative intraocular lens position (ie, tilt and decentration) was measured using Scheimpflug images (Pentacam; Oculus Optikgeräte GmbH, Wetzlar, Germany). There was no statistically significant difference in age, axial length, and follow-up time between the two groups (P > .05). Vertical tilt, horizontal and total decentration of intraocular lenses, and PCO proved to be significantly higher in the CCC group (P = .03, .04, .03, and .01, respectively). After adjusting for axial length and follow-up time, manual anterior capsulorhexis was found to be a significant predictor of higher PCO scores in the multivariable regression model (β: 0.33; 95% CI: 0.01 to 0.65; P = .04). Vertical tilt affected PCO scores after adjusting for axial length and follow-up time (β: 0.07; 95% CI: 0.01 to 0.12; P = .02). No capsulotomies were performed during follow-up in either group. Femtosecond laser-assisted anterior capsulotomy proved to be a safe procedure for postoperative PCO rates. Due to better intraocular lens position, femtosecond laser-assisted anterior capsulotomy resulted in slightly decreased PCO scores; however, evaluating its clinical significance requires further studies.

Anterior and posterior capsular opacification with the Tecnis ZCB00 and AcrySof SA60AT IOLs: a randomised intraindividual comparison

PurposeTo evaluate and compare the 1-year postoperative levels of posterior capsule opacification (PCO) as well as the level of anterior capsule retraction and opacification (ACO) after implantation of two single-piece...

Capsular bag stability and posterior capsule opacification of a plate-haptic design microincision cataract surgery intraocular lens: 3-year results of a randomised trial

PurposeTo compare capsular bag stability and posterior capsule opacification (PCO) of a plate-haptic intraocular lens (IOL) and a standard three-piece open-loop-haptic IOL of the same acrylic material.MethodsIn this randomised bilateral...

A Randomized, Single-Center Study of Equivalence of 2 Intraocular Lenses Used in Cataract Surgery

To compare the outcomes of 2 intraocular lenses (IOLs) for the treatment of age-related cataracts. Prospective, randomized trial. Patients with age-related cataracts were recruited and randomized to receive phacoemulsification and implantation of either the AcrySof SA60AT lens (Alcon, Inc, Fort Worth, TX) or the low-cost Tecsoft Flex lens (Fred Hollows Foundation, Tilganga, Nepal). A total of 300 patients were available for description and analysis (148 in the AcrySof group and 152 in the Tecsoft group). Patients underwent phacoemulsification and implantation of the AcrySof SA60AT lens or the Tecsoft Flex lens. They were followed up and examined at baseline, 1 week, 1 month, 6 months, and 12 months after cataract surgery. Uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BDVA), incidence of posterior capsule opacification (PCO), Visual Function Index questionnaire results, and safety of the implanted IOLs. No significant difference (P>0.05) was found in UDVA and BDVA after surgery between the 2 groups. The equivalence test of the 95% confidence intervals showed that both lenses had an equal improvement of UDVA and BDVA as well as similar rates of PCO after cataract surgery. There was no significant difference between the 2 groups with regard to visual functioning or the incidence of adverse surgical events during (P>0.05) or after (P>0.05) the surgery. The Tecsoft Flex IOL is a low-cost suitable alternative that is similar to the AcrySof IOL in terms of safety and visual outcomes.

Posterior capsule opacification following 20- and 23-gauge phacovitrectomy (posterior capsule opacification following phacovitrectomy)

To compare the development of posterior capsule opacification (PCO) for idiopathic epi-retinal membrane cases between 20- and 23-gauge phacovitrectomy. Cataract surgery of phacoemulsification with the SA60AT implantation and 20- or 23-gauge vitrectomy was performed for 20 patients in both groups. Cataract surgery alone was performed for 50 patients as the control. The PCO density values were measured using Scheimpflug video photography at 1 week, 1, 3, 6, 12, 18, and 24 months after surgery. The number of eyes that required Nd:YAG laser capsulotomy was also examined. The mean PCO value in the 20-gauge phacovitrectomy group increased significantly with time (P<0.001), whereas those in the 23-gauge phacovitrectomy group and the cataract surgery group did not show any significant change. Furthermore, the PCO value in the 20-gauge phacovitrectomy group was significantly greater than that in the 23-gauge phacovitrectomy group at 6, 12, 18 (P<0.05), and 24 months (P<0.01) after surgery. The PCO value in the 23-gauge phacovitrectomy group was significantly greater than that in the cataract surgery group 24 months after surgery (P<0.05). The rate of capsulotomy in the 20-gauge phacovitrectomy group was significantly higher than that in the cataract surgery group (P=0.007), whereas there was no significant difference between the 23-gauge phacovitrectomy group and the cataract surgery group. PCO rate in eyes with the 23-gauge phacovitrectomy was lower than in those with the 20-gauge phacovitrectomy, and PCO rate even in the 23-gauge phacovitrectomy was higher than in those with cataract surgery.

Intracameral mydriatics in phacoemulsification cataract surgery – a 6‐year follow‐up

To evaluate the long-term safety of intracameral mydriatics (ICM) in phacoemulsification cataract surgery compared with conventional topical mydriatics (TM). A total of 45 patients were examined 6 years after phacoemulsification cataract surgery. The patients had previously participated in a prospective randomized double-blind study including 60 patients, operated with either ICM or TM. The follow-up included best-corrected visual acuity (BCVA), intraocular pressure (IOP), grade of posterior capsule opacification (PCO), YAG laser capsulotomy rate, pupil size, corneal thickness and endothelial morphology. No differences in postoperative BCVA, IOP, pupil size, PCO or YAG rate were observed between the groups. Endothelial cell loss, endothelial morphology and corneal thickness were also equivalent. Intracameral mydriatics is a safe alternative to topical mydriatics in phacoemulsification cataract surgery with no long-term disadvantages at 6-year follow-up.

Posterior capsule opacification and capsular bag performance of a microincision intraocular lens

To assess the axial stability and posterior capsule opacification (PCO)-inhibiting efficacy of a microincision hydrophilic intraocular lens (IOL) (Idea 613 XC) and a standard hydrophobic open-loop acrylic IOL (Acrysof SA60AT). Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom. Clinical trial. Patients with bilateral cataract received a microincision cataract surgery (MICS) IOL in 1 eye and a small-incision cataract surgery (SICS) IOL in the contralateral eye. Follow-up examinations were performed immediately after surgery and postoperatively at 1 week and 3 and 24 months. Posterior capsule opacification was assessed using retroillumination photography. Anterior chamber depth (ACD) was measured using partial coherence laser interferometry, and IOL tilt and decentration were measured using a Purkinje meter. Seventy eyes (35 patients) were enrolled. The mean ACD at 3 months was 4.91 mm ± 0.26 (SD) in the MICS group and 4.60 ± 0.23 mm in the SICS group. The anterior IOL shift over the first 3 months was slightly smaller with the MICS IOL (81 μm) than with the SICS IOL (254 μm). The mean ACD was 0.377 ± 178 μm deeper with the MICS IOL (P<.01, paired t test). Two years postoperatively, the amount of regeneratory PCO was higher with the MICS IOL than with the SICS IOL (image analysis software score 2.6 versus 1.9; P=.005). Two years after surgery, the PCO rate was slightly higher with the MICS IOL. The 2 IOLs had similar performance in terms of axial stability, decentration, and tilt. No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.

Comparison of clinical outcomes between iris‐fixated anterior chamber intraocular lenses and scleral‐fixated posterior chamber intraocular lenses in Marfan syndrome with lens subluxation

To compare the clinical outcomes in Marfan's with subluxated lens having phaco-emulsification with simultaneous scleral-fixated posterior chamber intraocular lens or iris-fixated anterior chamber intraocular lens implantation. Randomized case series in the State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. Seventy-one eyes of 49 patients with Marfan syndrome with subluxated lens. This is a randomized case series of patients with Marfan syndrome and subluxated lenses who underwent phaco-emulsification combined with scleral-fixated posterior chamber intraocular lens or iris-fixated anterior chamber intraocular lens implantation. The evaluation indexes included the surgery time, best corrected visual acuity, intraocular pressure, aqueous flare and cells counts, corneal endothelium counts and complications. Increase in best corrected visual acuity in both groups was not significant. The aqueous flare and cells rose in both groups postoperatively. Significant difference between the two groups at 1 week postoperatively was found, whereas no statistically significant difference was found later. The loss rate of corneal endothelium cells in the scleral-fixated posterior chamber intraocular lens group was 13.2% and 19.5% at 3 months and 1 year postoperatively, which in the iris-fixated anterior chamber intraocular lens group was 13.3% and 19.3% (P > 0.05). Prolapse of vitreous was found in 21 cases intraoperatively. The posterior capsule opacification rate was 32% and 15%, respectively. The decentration of the intraocular lens was found in 19 eyes (48.7%) in the scleral-fixated posterior chamber intraocular lens group 1 year postoperatively, whereas none was found in the iris-fixated anterior chamber intraocular lens group. Iris-fixated anterior chamber intraocular lens after phaco-emulsification presented a safe, simple and efficient approach for managing subluxated lens in Marfan syndrome.

Factors Contributing to Posterior Capsule Opacification Following 23-Gauge Transconjunctival Phacovitrectomy

To determine posterior capsule opacification (PCO) rate and identify contributory factors in a series of patients undergoing combined 23-gauge transconjunctival phacovitrectomy. Retrospective data on 221 consecutive patients operated on by a single senior surgeon using a standard technique were collected and subjected to univariate analysis with chi-square tests and multivariate analysis with logistic regression. PCO developed in 46 of 221 cases (20.8%). Major risk factors were: rhegmatogenous retinal detachment (relative risk = 3.3, P = .002), axial length greater than 24.5 mm (relative risk = 2.0, P = .093), intraoperative/postoperative complications (relative risk = 3.3, P = .04), C2F6 tamponade (versus SF6/air) (relative risk = 2.8, P = .01), and postoperative posturing (relative risk = 4.1, P < .001). Multiple logistic regression analysis showed the latter two to be most important. PCO rate following 23-gauge phacovitrectomy is lower than most rates reported for 20-gauge phacovitrectomy. Using shorter-acting gas tamponade and avoiding postoperative posturing may help lower PCO rates.

Effect of anterior capsular polishing on the rate of posterior capsule opacification: A retrospective analytical study

AimTo determine whether anterior capsule polishing during cataract surgery done by phacoemulsification has any effect on the rate of posterior capsule opacification. Materials and methodsWe conducted a 3year retrospective analytical study at our hospital. The medical records of patients who underwent cataract extraction by phacoemulsification with foldable square edge hydrophilic PCIOL between April 2007 and March 2010 were reviewed.The study included 1009 eyes of 950 patients who underwent phacoemulsification with foldable square edge hydrophilic IOL in the bag implantation with anterior capsular polishing. The control group included 981 eyes of 957 patients in whom anterior capsular polishing was not done.Patients in the age group of 45–65years with well dilating pupils were included in the study. They were evaluated at 1week, 1month and 1year post-operatively. Exclusion criteria included glaucoma, shallow anterior chamber, uveitis, high myopia, pseudoexfoliation, diabetes mellitus, traumatic cataracts, posterior polar cataract, subluxated cataracts, previous ocular surgeries, patients allergic to dilating drops, and steroid intake. Intraoperatively, the exclusion criteria were not achieving the total anterior capsule cover on the IOL optic, sulcus fixated IOL, and any intraoperative complications like posterior capsule rupture. After bimanual irrigation/aspiration, all enrolled patients were randomly assigned to receive either 360 degree anterior capsular polishing or No anterior capsular polishing and results were studied. ResultsThe rate of posterior capsule opacification in the study group and in the control group was not statistically significant. ConclusionThough it was thought that anterior capsular polishing will lead to reduced rate of PCO formation, our study showed that there was no significant difference in PCO formation between the two groups. However, it was seen that the rate of anterior capsule opacification and capsular phimosis showed a significant reduction in cases in which anterior capsular polishing was done.

Two-year follow-up after implantation of diffractive aspheric silicone multifocal intraocular lenses

To evaluate the stability of visual performance after implantation of a diffractive aspheric silicone multifocal intraocular lens (MIOL). Thirty eyes of 15 patients received the Tecnis MIOL ZM900 (Abbot Medical Optics) after cataract extraction at Tokyo Dental College Suidobashi Hospital. The uncorrected and best-corrected distance visual acuities (UCDVA, BCDVA); uncorrected, distance-corrected and best-corrected near VAs (UCNVA, DCNVA and BCNVA); spherical equivalent refraction, spectacle independence, contrast sensitivity and posterior capsule opacification (PCO) were measured at 1 week; 1, 3 and 6 months; and 1 and 2 years postoperatively. Two years postoperatively, the UCDVA was 0.01 logMAR, BCDVA -0.09 logMAR, UCNVA 0.19 logMAR, DCNVA 0.1 logMAR and BCNVA 0.04 logMAR. There was no significant change from 1 week through 2 years. The percent of spherical equivalent refraction error within ± 0.5 diopter was 63.4% at 2 years. No patient required spectacles for reading; two patients have used spectacles for intermediate vision when necessary. One eye underwent Nd:YAG laser posterior capsulotomy because of PCO. The visual performance after implantation of the Tecnis MIOL was stable for 2 years. A low rate of PCO contributed to the long-term visual performance.