Effect of intraocular lens design on posterior capsule opacification

Abstract

Posterior capsule opacification (PCO) remains the most common long-term complication after cataract surgery. Many studies have attempted to identify factors that influence the development of PCO. The aim of this systematic review based on Cochrane methodology was to summarize the effects of intraocular lens (IOL) geometry, including modifications of the IOL optic (especially optic edge design) and haptics, on the development of PCO. Twenty-six prospective randomized controlled trials with a follow-up of at least 12 months were included. In 5 of 7 studies, visual acuity was better in sharp-edged IOLs than in round-edged IOL. The PCO score was significantly lower with sharp-edged IOLs but did not differ significantly between 1-piece and 3-piece open-loop IOLs. Because of the significant difference in the PCO score, sharp-edged IOL optics should be preferred to round-edged IOL optics.

Incidence of posterior capsule opacification following the implantation of a foldable hydrophilic acrylic intraocular lens: a 4 year follow-up study

“…This value is supported by data in the published literature, and confirms that it represents the most frequent cause of vision reduction following cataract surgery (7,15) . Only one patient presented IOL opacification, but we had previously reported, in another study with the same IOL, an incidence as high as 7% of long term IOL opacification, with no correlation to PCO (16) .…”

“…The IOL material and design is able to influence the incidence of PCO (5,7,8) . It has been well documented that a hydrophobic lens ma terial causes less PCO than a hydrophilic material, even though the latter is more uveal biocompatible (17,18) .…”

“…Although the Ioflex is a 1-piece lens, this not considered to be a factor in the development of PCO, since both 1-and 3-piece IOLs have been studied to evaluate their influence on PCO formation and no statistically significant differences between them have been found (28,29) . PCO is also age-dependent, being more frequently observed as a postoperative complication in young people and children (7,30) . This study evaluated an adult population and thus did not find a statistically significant difference on the independent analysis of age between patients with and without PCO.…”

“…Researchers are trying to identify the key factors in reducing the incidence of PCO (5,6) . It has already been demonstrated that sharp-edged intraocular lens (IOL) optics are preferable to round-edged IOL optics (7) . Modification of the IOL surface, which can inhibit cell and protein adhesion, has been suggested for reducing the incidence PCO (4) .…”

Bottom-up fabrication of zwitterionic polymer brushes on intraocular lens for improved biocompatibility

“…32 Various attempts, including improvement in surgical techniques, optimization of IOL design, investigation of novel IOL materials, as well as the use of pharmacological and immunological inhibitors of the LEC proliferation, have been taken to improve the IOL biocompatibility. [33][34][35][36][37][38] In addition, surface modification of implantable biomedical devices is an effective way to improve their biocompatibility. [3][4][5][6]39 Cell-resistant surface can be generated via hydrophilic macromolecule immobilization or hydrogel-like surface coating.…”