Effect of intraocular lens edge profile on posterior capsule opacification after extracapsular cataract surgery in a developing country.


Shah, A; Spalton, DJ; Gilbert, C; Vasavada, A; Boyce, JF; Minassian, D; Jayaram, H; Mabey, D; (2007) Effect of intraocular lens edge profile on posterior capsule opacification after extracapsular cataract surgery in a developing country. Journal of cataract and refractive surgery, 33 (7). pp. 1259-1266. ISSN 0886-3350 DOI: https://doi.org/10.1016/j.jcrs.2007.03.044

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Abstract

PURPOSE: To determine whether square-edged polymethyl methacrylate (PMMA) intraocular lenses (IOLs) reduce posterior capsule opacification (PCO) in the context of extracapsular cataract surgery in a developing country. SETTING: A rural hospital in India. METHODS: This was a prospective randomized double-masked fellow-eye controlled study. Over a 4-month period, 118 patients with normal eyes apart from age-related cataract were randomized to receive a square-edged or round-edged PMMA IOL in the first eye. The IOLs were identical apart from the edge profile. The fellow-eye had implantation of the alternative IOL within 1 month. Retroillumination images of the posterior capsule were taken using a dedicated camera system and analyzed to quantify the PCO area using POCO software 1 and 2 years postoperatively and the PCO area and severity using POCOman semiqualitative software at 2 years. Visual acuity was measured using a Gujarati logMAR chart. RESULTS: One hundred fifteen patients were available for examination at 1 year and 107 at 2 years. With POCO software, the PCO area was reduced in the square-edged IOL group at 1 year (median 30% versus 20%, P = .001) and at 2 years (median 45% versus 35%, P = .006). With POCOman, the PCO area and severity were reduced in the square-edged group at 2 years (median 41.5% versus 33.2%, P = .019 and 0.59 versus 0.46, P = .037, respectively). There was no significant difference in visual acuity between the 2 groups at 1 or 2 years. CONCLUSIONS: Sophisticated image analysis techniques can be used in developing countries to quantify PCO. Using extracapsular surgery, square-edged PMMA IOLs reduced the PCO area and severity compared with an identical round-edged IOL; however, the differences were not as marked as those reported with phacoemulsification. This may be due to the difficulty of performing a capsulorhexis that lies on the IOL surface in this situation. Nevertheless, square-edged IOLs offer a potential benefit for extracapsular surgery in the developing world.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: The International Centre for Evidence in Disability
International Centre for Eye Health
Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 17586384
Web of Science ID: 247948200028
URI: http://researchonline.lshtm.ac.uk/id/eprint/9762

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