Quantification of posterior capsule opacification with round and sharp edge intraocular lenses

PURPOSE: To quantitatively evaluate and compare intraocular lenses (IOLs) with a round or sharp optic edge design for posterior capsule opacification (PCO). STUDY DESIGN: Prospective comparative observational case series. PARTICIPANTS/MATERIALS: Photographs from 174 eyes were analyzed for PCO at the Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany. MAIN OUTCOME MEASURES: Part I: 121 eyes of 121 patients were analyzed for quantification of PCO. IOLs evaluated were Corneal ACR6 (n = 21), Alcon Acrysof (n = 20), Allergan AR40 (n = 27), Pharmacia 811 one-piece polymethyl methacrylate (PMMA) IOL (n = 24), and Pharmacia 911A silicone IOL (n = 29). Mean follow-up was 14.01 +/- 2.81 months; mean patient age was 73.2 +/- 7.3 years. The morphologic PCO formation was evaluated for the entire optic and in the central 3-mm zone. Part II: In 53 eyes of 46 patients aged 73.4 +/- 10.8 years with an Alcon Acrysof IOL, PCO formation and capsulorrhexis/optic overlapping were analyzed 34.2 +/- 4 months after cataract surgery using EPCO Software. RESULTS: Part I: The PCO values of the entire optic were for Corneal ACR6, 1.93 +/- 0.62; PMMA, 0.64 +/- 0.63; AR40, 0.55 +/- 0.28; Alcon Acrysof, 0.145 +/- 0.27; and 0.161 +/- 0.181 for the Pharmacia 911A IOL (P < 0.01). The PCO values of the central 3-mm zone were for Corneal ACR6, 1.64 +/- 0.96; PMMA, 0.49 +/- 0.39; AR40, 0.22 +/- 0.32; Alcon Acrysof, 0.08 +/- 0.21; and 0.06 +/- 0.11 for the Pharmacia 911A IOL (P < 0.01). Part II: Average overlapping of capsulorrhexis and Acrysof IOL optic was 40.5% +/- 12.4%. There was a significant correlation between PCO values and overlapping (r = -0.69, P < 0.001). CONCLUSIONS: The sharp-edge IOL types (Alcon Acrysof and Pharmacia 911A silicone IOL) resulted in statistically significantly lower PCO values for analysis of the entire optic area and central 3-mm zone. There was no statistically significant difference in PCO values between the two sharp-edge optic IOLs. An overlapping of capsulorrhexis rim and the anterior IOL optic surface of more than 20% resulted in significantly lower PCO values with the Acrysof IOL.