The Madurai Intraocular Lens Study IV: Posterior capsule opacification

PURPOSE: To estimate the cumulative incidence of posterior capsule opacific ation 4 years after surgery in patients who participated in the Madurai Int raocular Lens Study and had extracapsular cataract extraction with posterio r chamber intraocular lens implantation, METHODS: In the Madurai Intraocular Lens Study, 1,700 patients with best-co rrected visual acuity 20/120 or worse in the better eye had extracapsular c ataract extraction with posterior chamber intraocular lens implantation, an d 1,474 (86.7%) of these completed the 1-year follow-up examination. From t his group of 1,474 pseudophakic patients, 400 were randomly selected for re examination 4 years after the original surgery. The eye that was operated o n was examined by an ophthalmologist who was involved in the 1-year follow- up examinations and posterior capsule opacification grading. A grading of I to III was used to reflect the degree of opacification. With grades II and III, posterior capsule opacification detectable with an undilated pupil wa s present in the central axis, RESULTS: Three hundred twenty-seven (81.8%) of the selected population were examined between October 1997 and December 1998. Thirty-four (8.5%) were c onfirmed as being deceased, and 39 (9.8%) were unavailable for follow-up. T he median age was 60 years, and 57.2% were women. The 4-year incidence of g rade II or III posterior capsule opacification, including eyes already trea ted with laser capsulotomy, was 13.1% (95% confidence interval [CI], 9.7% t o 17.3%). Each year of increased age was associated with a decreased risk o f posterior capsule opacification (odds ratio, 0.96; 95% CI, 0.92 to 1.00). Based on best-corrected visual acuity of 20/40 or worse without co-existin g pathology, the 4-year incidence of posterior capsule opacification was 13 .5%. CONCLUSION: Because patients with relatively mature cataracts routinely rec eive extracapsular cataract extraction with posterior chamber intraocular l ens implantation instead of the traditional intracapsular extraction, the s ubsequent need for laser capsulotomy may be less than that anticipated, bas ed on previous reports, (C) 2000 by Elsevier Science Inc. All rights reserv ed.