Effect of intraocular lens size on posterior capsule opacification after phacoemulsification

Abstract

Posterior capsule opacification (PCO) is one of the most common complications of phacoemulsification with intraocular lens (IOL) implantation. This retrospective study evaluated the incidence of neodymium: YAG (Nd:YAG) laser capsulotomies for PCO in two groups of patients with different sizes of poly(methyl methacrylate) (PMMA), capsular bag-fixated IOLs. We evaluated 437 eyes that had phacoemulsification with continuous curvilinear capsulorhexis over a four-year period. Patients were placed in one of two groups, based on IOL size: large IOL (lens length 13.5 mm or greater) and small IOL (lens length less than 13.5 mm). In the large IOL group, 106 of 280 patients (38%) required YAG laser posterior capsulotomy; in the small IOL group, 25 of 157 patients (16%) did. This difference was statistically significant even though the average follow-up was 84.1 weeks in the large IOL group and 54.1 weeks in the small IOL group.

The Study of Late Post Operative Complications (Pco) Following Small Incision Cataract Surgery with Square Edged Rigid/ Foldable Intraocular Lens Implantation

“…Finally a successful expansion of SICS with IOL surgery in the developing world depends on eradication, or at least reduction of PCO, since patient follow up is difficult and access to the Nd : Yag laser is not widely available. 4 In our study visually significant PCO is noted in 5.3% of patients having undergone SICS with PCIOL after one year similar findings reported by Mannalis N et al 5 Regarding the surgical technique, cortical cleaving hydrodissection of nucleus followed by its rotation during SICS results in removal of maximum lens fibers and epithelial cells at the equator of the capsular bag thereby reducing the chances of PCO. By freeing and rotating the lens nucleus, hydrodissection facilitates lens nucleus and cortex removal without zonular -capsular -rupture.…”

Neodymium:YAG laser posterior capsulotomy after implantation of AcrySof intraocular lenses

“…(Davison) A scanning electron micrograph of a piece of In contrast, this relationship was not found in a study a 22-gauge needle used to dislodge material that was obstructing comparing 6.0 mm and 7.0 mm PMMA optics,59 in the aperture of the 0.2 mm I/A tip. A metal fragment from the needle was inadvertently imbedded into the surface of the 0.2 mm I/A tip.…”

Evaluation of the effects of hydrodissection with antimitotics using a rabbit model of Soemmering’s ring formation

“…Advances in surgical technique, intraocular lens (IOL) design and materials have all contributed to the gradual decline in PCO incidence. However, it remains a major cause of decreased visual acuity after cataract surgery occurring at a rate of 3–50% in the first five postoperative years 1–4 . PCO has been shown to result from migration and proliferation of residual lens epithelial cells (LECs) onto the central posterior capsule and subsequently the visual axis 5 …”