Posterior capsule opacification and lens epithelial cell layer formation: Hydroview hydrogel versus AcrySof acrylic intraocular lenses

Abstract

Purpose: To quantitatively compare the incidence of visually significant posterior capsule opacification (PCO) and lens epithelial cell (LEC) layer formation on the anterior surface of Hydroview® hydrogel and AcrySof® acrylic foldable intraocular lenses (IOLs) after implantation. Setting: Single-surgeon ophthalmology practice, Orange Base Hospital, and Dudley Private Hospital, Orange, New South Wales, Australia. Methods: This retrospective study comprised 166 eyes of 150 patients (after exclusions) who had cataract extraction and insertion of a foldable IOL in the capsular bag by a single surgeon using a standardized phacoemulsification technique from December 1997 to September 1998. The mean follow-up was 13.1 months (range 6.0 to 23.6 months). The eyes were divided into 2 groups based on the type of IOL implanted: Storz Hydroview H60M (81 eyes) or Alcon AcrySof MA30BA (85 eyes). A neodymium:YAG posterior capsule laser capsulotomy (PC YAG) was performed for an objective decrease in Snellen best corrected visual acuity (BCVA) of more than 1 line, significant visual symptoms, or both. This was used as a measure of visually significant PCO. An Nd:YAG anterior surface clearance (ASC YAG) was done for LEC layer formation anterior to the IOL to better visualize or facilitate treatment of PCO. The rates of PC YAG and ASC YAG after Hydroview and AcrySof IOL implantation were statistically compared. Results: Forty-five eyes (55.6%) in the Hydroview IOL group and 3 eyes (3.5%) in the AcrySof IOL group required a PC YAG; the risk difference was 52.0% (P < .001). An ASC YAG was required in 27 eyes (33.3%) in the Hydroview group and 1 eye (1.2%) in the AcrySof group; the risk difference was 32.2% (P < .001). Survival analysis demonstrated that the only independent predictor of the incidence of PC YAG and ASC YAG over time was IOL type, with the Hydroview IOL group having a statistically significantly higher incidence of both procedures. Conclusion: There was a greater incidence of visually significant PCO and LEC layer formation on the anterior surface of Hydroview IOLs than of AcrySof IOLs.