CHANGE IN CAPSULORHEXIS SIZE AFTER IMPLANTATION OF 3 TYPES OF INTRAOCULAR LENSES

Purpose: To compare the change in size of continuous curvilinear capsu lorhexis (CCC) used for implantation of three types of intraocular len ses (IOLs) and to determine the role of postoperative inflammation, in itial CCC dimension, haptic design, and optic material. Setting: Hopit al Ophtalmique Universitaire Jules Gonin, Lausanne, Switzerland.Method : Twenty-nine three-piece, silicone:poly(methyl methacrylate) (PMMA) I OLs (lovision 127), 26 one-piece PMMA IOLs (Pharmacia 812A), and 27 pl ate-haptic silicone IOLs (Staar AA4203) were implanted in the capsular bag after phacoemulsification. Photographs of the CCCs taken 1 day an d 6 months after surgery were scanned and digitized on a computer. Usi ng different software, the surface of the CCC was measured and the 6 m onth change evaluated. Flare, measured the day before surgery and post operatively at days 1, 7, 30, and 180, was integrated to obtain a glob al estimate of inflammation during the 180 day follow-up. Results: The CCCs used with three-piece, silicone/PMMA IOLs showed little changes in surface, with a mean enlargement of +0.57 mm(2) +/- 1.15 (SD) (+3.5 %). The CCCs used with the one-piece PMMA IOLs had a slight tendency t o constrict, with a mean surface decrease of -0.59 +/- 2.16 mm(2) (-4. 3%). The CCCs used with plate-haptic silicone IOLs showed a marked and statistically significant constriction, with a mean decrease of -2.55 +/- 3.51 mm(2) (-14.4%). The change in CCC size was not associated wi th the integrated flare, and no correlation was found between the init ial CCC size and the magnitude of change. There was no statistically s ignificant difference in CCC change between the PMMA optic IOL (Pharma cia) and silicone optic IOL (lovision and Staar) groups. The CCC in th e plate-haptic IOL (Staar) group showed a significant (P < .0002) cons triction when compared with that in the loop-haptic IOL (Pharmacia and lovision) group. Conclusion: The IOLs' haptic design seemed to play a major role in the evolution of the CCC. The CCC constriction seen wit h the Staar IOLs was related to their plate haptics.