Effect of optic size on posterior capsule opacification: 5.5 mm versus 6.0 mm AcrySof intraocular lenses

Abstract
Purpose: To determine the effect of intraocular lens (IOL) optic diameter on posterior capsule opacification (PCO) using digital retroillumination images. Setting: Eye Department, St. Thomas' Hospital, London, United Kingdom. Methods: In this prospective study, 60 patients with senile cataract had routine phacoemulsification by a single surgeon and received standardized medication. The patients were divided into 2 equal groups. The first group received a 5.5 mm 3-piece AcrySof IOL (MA30BM, Alcon) inserted in the bag. The second group received a 6.0 mm 3-piece AcrySof IOL (MA60BM, Alcon). Retroillumination images were obtained 1, 30, 90, 180, and 360 days postoperatively. The percentage area of PCO was calculated objectively by dedicated software at 90, 180, and 360 days. At 1 day, the degree of capsulorhexis-IOL contact was determined by inspecting the images. Results: Throughout the follow-up, there was less PCO in the 6.0 mm optic group than in the 5.5 mm optic group, and the difference reached significance 1 year postoperatively (P = .0017). At 1 year, the median percentage of PCO was 1.5% (95% confidence interval [CI] 1.4-5.3) in the 6.0 mm group and 6.9% (95% CI 5.8-18.0) in the 5.5 mm group. Conclusions: A larger IOL optic diameter was associated with less PCO.