Choice of intraocular lens may not affect refractive stability following cataract surgery

PURPOSE: To assess whether the choice of an intraocular lens (IOL) with rigid haptics (Sensar) or an IOL with pliable haptics (Acrysof) has an effect on refractive stability following cataract surgery. METHODS: Seventy-three patients were recruited consecutively as they returned for their 6-month visit following cataract surgery. There were 37 patients who had received an Acrysof IOL and 36 who had received a Sensar IOL. Each patient had their refractive error measured at the 1-month postoperative visit. At the 6-month follow-up visit, refraction was repeated. The change in refractive error was then compared between IOL groups and other factors that may affect postoperative refractive stability including preoperative refraction, axial length, keratometry, wound type and wound meridian. RESULTS: An Acrysof IOL showed minimal myopic movement, whereas a Sensar IOL was more likely to move hypermetropically. However, this difference was not statistically significant (t=1.92; P=0.06). The magnitude of the shift in spherical equivalent in either direction for the Acrysof group was 0.37 +/- 0.35 D and for the Sensar group was 0.28 +/- 0.31 D. Again, this difference was not statistically significant (t=1.17; P=0.25). However, preoperative anterior chamber depth was associated with postoperative refractive shift (t=2.66; P=0.009). Furthermore, patients with a scleral wound showed a small against-the-rule shift in cylindrical refractive error. No other factors were associated with postoperative refractive shift amongst the sample. CONCLUSIONS: There were no clinically significant differences in postoperative refractive stability between the Acrysof and Sensar groups. However, preoperative anterior chamber depth was associated with the magnitude of shift in spherical equivalent.